结直肠手术部位感染的预防策略。
Colorectal surgical site infection reduction strategies.
作者信息
DeHaas David, Aufderheide Steven, Gano Jan, Weigandt Julie, Ries Jan, Faust Bobbi
机构信息
Sacred Heart Medical Center at Riverbend, 3333 Riverbend Dr, Springfield, OR 97477.
Sacred Heart Medical Center at Riverbend, 3333 Riverbend Dr, Springfield, OR 97477.
出版信息
Am J Surg. 2016 Jul;212(1):175-7. doi: 10.1016/j.amjsurg.2016.04.001. Epub 2016 May 7.
OBJECTIVE
PeaceHealth Sacred Heart Medical Center at RiverBend is a 379 bed hospital; 15,060 surgical procedures were performed in 2014 with 254 being colorectal surgical cases. Using the ACS NSQIP program the hospital was identified as a high outlier for surgical site infection (SSI) in all cases and in colorectal procedures in our July 2012 semiannual report (SAR).
METHODS
A best practice bundle to reduce SSI's and a colorectal enhanced recovery pathway were concurrently initiated
RESULTS
After implementation of these best practice elements, our ACS NSQIP results showed a reduction in our colorectal SSI rate from 17.58% for 2011 to 5.11% (1st decile/low outlier) in the January 2015 SAR. Our SSI rate for all cases were reduced from 4.87% to 1.71% (1st decile/low outlier) during the same time period. A reduction in length of stay for our colorectal surgical patients was also noted.
CONCLUSIONS
The ACS NSQIP program was essential to identify colorectal SSI as an area of concern and for providing data to drive quality improvement measures.
目的
位于河湾的和平健康圣心医疗中心是一家拥有379张床位的医院；2014年共进行了15,060例外科手术，其中254例为结直肠外科病例。在我们2012年7月的半年报（SAR）中，通过美国外科医师学会国家外科质量改进计划（ACS NSQIP），该医院被认定为所有病例以及结直肠手术外科手术部位感染（SSI）的高度异常值。
方法
同时启动了一套旨在降低SSI的最佳实践方案和一条结直肠强化康复路径。
结果
实施这些最佳实践要素后，我们的ACS NSQIP结果显示，结直肠SSI率从2011年的17.58%降至2015年1月半年报中的5.11%（第一十分位数/低异常值）。同期，所有病例的SSI率从4.87%降至1.71%（第一十分位数/低异常值）。我们还注意到结直肠手术患者的住院时间有所缩短。
结论
ACS NSQIP计划对于将结直肠SSI确定为一个需要关注的领域以及提供数据以推动质量改进措施至关重要。
Zotero 插件