Department of Epidemiology, Infection Prevention, Lee Memorial Health System, HealthPark Medical Center, 9981 S HealthPark Dr, Fort Myers, FL.
Am J Infect Control. 2011 Oct;39(8):678-684. doi: 10.1016/j.ajic.2010.11.002. Epub 2011 Apr 2.
Surveillance and management of health care-associated infections (HAIs) has traditionally relied on analyses of outcome data to elucidate trends in HAI incidence, discover host or treatment risk factors, and facilitate comparisons of HAI rates within and among licensed providers or facilities. This paper explores residual gaps and shortcomings associated with outcome reporting and possible sources of bias that may invalidate intra- and interfacility comparisons. As an alternative to outcome surveillance and reporting, real-time process monitoring and control is proposed. To address the need for uncompromising conformity with preventive measures, the concepts of social entropy, authority, responsibility, and accountability are explored and linked to process control at the bedside.
传统上，对卫生保健相关感染（HAI）的监测和管理依赖于对结果数据的分析，以阐明 HAI 发生率的趋势，发现宿主或治疗风险因素，并促进在许可提供者或设施内和之间比较 HAI 率。本文探讨了与结果报告相关的剩余差距和缺点，以及可能导致无效的内部和设施间比较的偏倚来源。作为结果监测和报告的替代方法，提出了实时过程监测和控制。为了解决不妥协地遵守预防措施的需要，探讨了社会熵、权威、责任和问责制的概念，并将其与床边的过程控制联系起来。
