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一种预防艰难梭菌感染的多方面方法

A Multifaceted Approach to the Prevention of Clostridioides (Clostridium) Difficile.

作者信息

Pate Kimberly, Reece Jennifer, Smyre Alex

机构信息

Author Affiliations: Clinical Nurse Specialist, Surgical-Trauma Division (Ms Pate), Infection Preventionist (Ms Reece), and Data Analyst, Infection Prevention (Ms Smyre), Carolinas Medical Center, Charlotte, North Carolina.

出版信息

Clin Nurse Spec. 2019 Mar/Apr;33(2):75-81. doi: 10.1097/NUR.0000000000000426.

Abstract

PURPOSE/OBJECTIVES: The purpose of this project was to design and implement a sustainable program to reduce hospital-acquired cases of Clostridioides difficile.

DESCRIPTION OF THE PROJECT

Experiencing higher rates in a large, academic medical center, hospital leaders were assembled. The overall facility rate was 6.9% in 2014 with a first quarter rate of 8.4% in 2015. Individual unit rates were as high as 19.8%. A team of key stakeholders was assembled to plan, execute, and reevaluate targeted solutions. Strategies implemented were an innovative, automated screening tool, an evidence-based prevention bundle; and staff education.

OUTCOMES

A facility-wide C difficile prevention program was implemented with a sustained decrease in rates observed from 8.4% in the first quarter of 2015 to 6.0% in the fourth quarter of 2017. The standardized infection ratio ranged from 0.541 to 0.889, consistently below the national mean.

CONCLUSION

Clostridioides difficile is a leading cause of hospital-associated diarrhea and a tremendous burden on healthcare systems increasing morbidity, mortality, and financial strain. A multidisciplinary, multifaceted approach was critical to ensure early detection, reduce risk of transmission, and decrease overall rates.

摘要

目的/目标:本项目的目的是设计并实施一项可持续计划,以减少医院获得性艰难梭菌感染病例。

项目描述

在一家大型学术医疗中心,艰难梭菌感染率较高,医院领导们齐聚一堂。2014年全院感染率为6.9%,2015年第一季度感染率为8.4%。个别科室感染率高达19.8%。组建了一个关键利益相关者团队,以规划、执行和重新评估针对性解决方案。实施的策略包括一种创新的自动化筛查工具、基于证据的预防措施组合以及员工教育。

结果

实施了全院范围的艰难梭菌预防计划,感染率持续下降,从2015年第一季度的8.4%降至2017年第四季度的6.0%。标准化感染比值在0.541至0.889之间,始终低于全国平均水平。

结论

艰难梭菌是医院相关性腹泻的主要病因,给医疗系统带来巨大负担,增加了发病率、死亡率和经济压力。多学科、多方面的方法对于确保早期发现、降低传播风险和降低总体感染率至关重要。

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