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N Engl J Med. 2011 Apr 14;364(15):1419-30. doi: 10.1056/NEJMoa1007474.
2
Intervention to reduce transmission of resistant bacteria in intensive care.重症监护中减少耐药菌传播的干预措施。
N Engl J Med. 2011 Apr 14;364(15):1407-18. doi: 10.1056/NEJMoa1000373.
3
Impact of nosocomial infections on clinical outcome and resource consumption in critically ill patients.医院感染对重症患者临床转归和资源消耗的影响。
Intensive Care Med. 2010 Sep;36(9):1597-601. doi: 10.1007/s00134-010-1941-2. Epub 2010 Jul 8.
4
Systematic patients' hand disinfection: impact on meticillin-resistant Staphylococcus aureus infection rates in a community hospital.系统的患者手部消毒:对社区医院耐甲氧西林金黄色葡萄球菌感染率的影响。
J Hosp Infect. 2010 Aug;75(4):269-72. doi: 10.1016/j.jhin.2010.02.028. Epub 2010 Jun 18.
5
Alexander Gordon, puerperal sepsis, and modern theories of infection control--Semmelweis in perspective.亚历山大·戈登、产褥期败血症和现代感染控制理论——从现代视角看塞麦尔维斯。
Lancet Infect Dis. 2010 Apr;10(4):275-8. doi: 10.1016/S1473-3099(09)70304-4.
6
Protecting healthcare workers from pandemic influenza: N95 or surgical masks?保护医护人员免受流感大流行的侵害:N95 口罩还是外科口罩?
Crit Care Med. 2010 Feb;38(2):657-67. doi: 10.1097/ccm.0b013e3181b9e8b3.
7
Surgical mask vs N95 respirator for preventing influenza among health care workers: a randomized trial.外科口罩与N95呼吸器预防医护人员流感的随机试验
JAMA. 2009 Nov 4;302(17):1865-71. doi: 10.1001/jama.2009.1466. Epub 2009 Oct 1.
8
A quantitative assessment of the efficacy of surgical and N95 masks to filter influenza virus in patients with acute influenza infection.对手术口罩和N95口罩过滤急性流感感染患者体内流感病毒效果的定量评估。
Clin Infect Dis. 2009 Jul 15;49(2):275-7. doi: 10.1086/600041.
9
Methicillin-resistant Staphylococcus aureus central line-associated bloodstream infections in US intensive care units, 1997-2007.1997 - 2007年美国重症监护病房耐甲氧西林金黄色葡萄球菌中心静脉导管相关血流感染情况
JAMA. 2009 Feb 18;301(7):727-36. doi: 10.1001/jama.2009.153.
10
Care of children isolated for infection control: a prospective observational cohort study.为感染控制而隔离儿童的护理:一项前瞻性观察队列研究。
Pediatrics. 2008 Aug;122(2):e411-5. doi: 10.1542/peds.2008-0181.

正反方辩论:在加强医疗单位,隔离预防措施是否能以成本效益改善病人的预后?

Pro/con debate: are barrier precautions cost-effective in improving patient outcomes in the intensive care unit?

机构信息

Division of Infectious Diseases, Department of Medicine, Mount Sinai Hospital and University Health Network, Department of Medicine, University of Toronto, 600 University Avenue, Suit 415, Toronto, ON M5G 1X5, Canada.

出版信息

Crit Care. 2012 Jan 19;16(1):202. doi: 10.1186/cc10532.

DOI:10.1186/cc10532
PMID:22264293
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3396214/
Abstract

You are responsible for a large medical surgical ICU. Your hospital administration has been very focused on reducing rates of hospital-acquired infections particularly in the wake of increasing public attention. However, it is time for budget preparation and your financial officer is concerned about the escalating costs associated with patient isolation and barrier precautions/personal protective equipment. Having become aware of the high costs associated with these interventions, you start to wonder about the wisdom of spending so much in this area. Your hospital administration wants your direction on next year's expenditures. You are debating whether the expense is worthwhile and advise your hospital administration accordingly.

摘要

你负责一个大型的外科重症监护病房。由于公众关注度的不断提高,医院管理层一直非常关注降低医院获得性感染的发生率。但是,现在是编制预算的时候了,你的财务人员担心与患者隔离和屏障预防措施/个人防护设备相关的成本不断上升。由于已经意识到这些干预措施的高成本,你开始怀疑在这方面投入这么多是否明智。医院管理层希望你对明年的支出方向提出意见。你正在考虑这些费用是否值得,并就此向医院管理层提出建议。