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[重症监护病房的质量指标:一项为期两年的医疗相关感染监测计划]

[Quality indicators in an intensive care unit: a two-year healthcare-associated infection surveillance program].

作者信息

Pita M J, Díaz-Agero C, Robustillo A, Prieto I, Gómez P, Monge V

机构信息

Servicio de Medicina Preventiva, Hospital Ramón y Cajal, Madrid, España.

出版信息

Rev Calid Asist. 2012 Mar-Apr;27(2):103-7. doi: 10.1016/j.cali.2011.09.011. Epub 2011 Dec 15.

Abstract

OBJECTIVE

To estimate quality healthcare indicators in an intensive care unit (ICU).

METHODS

A prospective observational study was conducted on all patients referred to the medical ICU of Ramón y Cajal hospital (Madrid) for more than 48 hours, from January 1 2008 to December 31 2009.

RESULTS

A total of 503 patients were included, of whom 7.4% developed a healthcare-associated infection (HAI) attributable to their stay in the ICU. The median length of stay was 5 days. A ventilator-associated pneumonia (VAP) was observed in 1.9% of patients, with a VAP rate of 3.8 per 1,000 ventilator-days. A catheter-associated urinary tract infection (CAUTI) was found in 3.6% of the patients, with a CAUTI rate of 4.5 per 1,000 catheter-days. The cumulative incidence of central line-associated bloodstream infection (CLABSI) was 1.8%, with a CLABSI rate of 2.2 per 1,000 central line-days.

CONCLUSIONS

Our results are similar to those of other studies using the same methodology. An HAI surveillance system is a key factor for implementing a healthcare quality improvement system. The obtained indicators allow intra-comparison over time and with other similar hospitals, the monitoring of infection control measures, and thus an effective improvement in healthcare quality and patient safety.

摘要

目的

评估重症监护病房(ICU)的优质医疗指标。

方法

对2008年1月1日至2009年12月31日期间转诊至拉蒙·伊·卡哈尔医院(马德里)内科ICU且住院时间超过48小时的所有患者进行前瞻性观察研究。

结果

共纳入503例患者,其中7.4%因入住ICU发生了医疗相关感染(HAI)。中位住院时间为5天。1.9%的患者发生了呼吸机相关性肺炎(VAP),VAP发生率为每1000呼吸机日3.8例。3.6%的患者发生了导管相关性尿路感染(CAUTI),CAUTI发生率为每1000导尿管日4.5例。中心静脉导管相关血流感染(CLABSI)的累积发生率为1.8%,CLABSI发生率为每1000中心静脉导管日2.2例。

结论

我们的结果与其他采用相同方法的研究结果相似。HAI监测系统是实施医疗质量改进系统的关键因素。所获得的指标允许进行时间上的内部比较以及与其他类似医院的比较,监测感染控制措施,从而有效提高医疗质量和患者安全。

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