Pfaff Barbara, Heithaus Teresa, Emanuelsen Madeline
Staten Island University Hospital, 475 Seaview Ave, Staten Island, NY 10305, USA.
Crit Care Nurse. 2012 Aug;32(4):35-40. doi: 10.4037/ccn2012956.
New transparent dressings with chlorhexidine gluconate in the dressing are available.
To compare the effectiveness of a new 1-piece occlusive dressing that incorporates chlorhexidine gluconate with that of a dressing plus a chlorhexidine gluconate patch in maintaining the low rate of catheter-related bloodstream infections in the intensive care unit and to evaluate nurses' satisfaction with and cost of the new dressing.
A quality improvement observational study was done in an adult medical-surgical intensive care unit. All patients with a central venous catheter had initial and/or subsequent dressing changes done with the new dressing. The central catheter bundle elements of the Institute for Healthcare Improvement were followed. Patients were monitored for catheter-related bloodstream infections, and the rate of infection was calculated.
During the study period of 1881 device days, the infection rate was 0.051 per 1000 device days, compared with a rate of 0.052 in 2008. Nurses preferred the new dressing. Cost savings were $3807.
A low rate of catheter-related bloodstream infections can be maintained, nurses' satisfaction achieved, and cost savings realized with the new dressing.
现在有敷料中含有葡萄糖酸氯己定的新型透明敷料。
比较含葡萄糖酸氯己定的新型一体式封闭敷料与敷料加葡萄糖酸氯己定贴片在重症监护病房维持低导管相关血流感染率方面的有效性，并评估护士对新型敷料的满意度及成本。
在一个成人内科-外科重症监护病房进行了一项质量改进观察性研究。所有中心静脉导管患者的初始和/或后续敷料更换均使用新型敷料。遵循医疗保健改进研究所的中心导管捆绑要素。对患者进行导管相关血流感染监测，并计算感染率。
在1881个装置日的研究期间，感染率为每1000个装置日0.051，而2008年为0.052。护士更喜欢新型敷料。节省成本3807美元。
新型敷料可维持低导管相关血流感染率，实现护士满意度，并节省成本。
