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英国急性医院未来的手术部位感染监测重点。

Future priorities of acute hospitals for surgical site infection surveillance in England.

机构信息

Department of Healthcare-Associated Infection and Antimicrobial Resistance, National Infection Service, Public Health England, London, UK.

Statistics, Modelling and Economics Department, National Infection Service, Public Health England, London, UK.

出版信息

J Hosp Infect. 2018 Dec;100(4):371-377. doi: 10.1016/j.jhin.2018.06.016. Epub 2018 Jun 23.

Abstract

BACKGROUND

Since the launch of the national Surgical Site Infection (SSI) Surveillance Service in 1997, successive expansions of the programme provided hospitals with increasing flexibility in procedures to target through surveillance. Ensuring that the programme continues to meet hospitals' needs remains essential.

AIM

As a means to inform the future direction of the service, a survey of all acute National Health Service trusts was undertaken to assess and understand priorities for surveillance.

METHODS

A web-based survey was circulated to acute NHS trust infection control teams in England, asking them to identify and rank (i) reasons for undertaking current SSI surveillance, (ii) priority surgical categories for future SSI surveillance, and (iii) reasons for prioritizing these categories.

FINDINGS

Of the 161 trusts surveyed, 84 (52%) responded. Assessment of quality of care was identified as the most common driver for SSI surveillance activity. Considerable heterogeneity in priority areas was observed, with 24 different surgical categories selected as top priority. Of the procedures undertaken by 15 or more trusts, caesarean section (2.7), hip replacement (2.8) and coronary artery bypass graft (2.9) were highest ranked. All 17 categories in the current surveillance programme were selected as a top priority by one or more trusts.

CONCLUSION

Whereas the majority of hospitals' priorities for SSI surveillance are included in the current programme, the top-ranked priority, caesarean section, is not included. Given the diversity of priority areas, maintaining a comprehensive spectrum of categories in the national programme is essential to assist hospitals in addressing local priorities.

摘要

背景

自 1997 年启动国家手术部位感染(SSI)监测服务以来,该项目的连续扩展为医院提供了通过监测来针对不同程序的更大灵活性。确保该项目继续满足医院的需求仍然至关重要。

目的

作为为该服务提供未来方向的一种手段,对所有英国国家医疗服务体系(NHS)的急性信托医院进行了一项调查,以评估和了解监测的优先事项。

方法

对英格兰 NHS 信托医院感染控制团队进行了一项基于网络的调查,要求他们确定并对(i)进行当前 SSI 监测的原因,(ii)未来 SSI 监测的优先手术类别,以及(iii)对这些类别进行优先排序的原因进行排名。

结果

在接受调查的 161 家信托中,有 84 家(52%)做出了回应。评估护理质量被认为是 SSI 监测活动的最常见驱动因素。优先领域存在相当大的异质性,有 24 个不同的手术类别被选为首要优先事项。在有 15 家或以上医院开展的手术中,剖宫产(2.7)、髋关节置换术(2.8)和冠状动脉旁路移植术(2.9)的排名最高。当前监测计划中的所有 17 个类别都被一家或多家医院选为首要优先事项。

结论

尽管大多数医院对 SSI 监测的优先事项都包含在当前计划中,但排名最高的优先事项剖宫产并不包括在内。鉴于优先领域的多样性,在国家计划中保持广泛的类别范围对于帮助医院解决当地的优先事项至关重要。

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