黎巴嫩4个重症监护病房实现中心静脉导管相关血流感染率为零

Achieving a Zero Central Line-Associated Bloodstream Infection Rate in 4 Critical Care Units in Lebanon.

作者信息

Jamous Sabath, Kouatly Iman, Zaatari Rafika, Kurdahi Badr Lina

机构信息

American University of Beirut Medical Center, Beirut, Lebanon (Mss Jamous, Kouatly, and Zaatari); and Azusa Pacific University, Azusa, California (Dr Badr). Sabath Jamous, MSN, RN, is a clinical nurse specialist in the intensive care unit (ICU) at the American University of Beirut Medical Center (AUBMC) in Beirut, Lebanon. Iman Kouatly, MPH, RN, is the director of nursing at the AUBMC. Rafika Zaatari, MSN, RN, is a clinical educator in the ICU at the AUBMC. Lina Kurdahi Badr, PhD, RN, PNP, FAAN, is a professor of nursing at Azusa Pacific University in Azusa, California.

出版信息

J Infus Nurs. 2019 Sep/Oct;42(2):249-253. doi: 10.1097/NAN.0000000000000335.

DOI:10.1097/NAN.0000000000000335

PMID:31464833

Abstract

Every health care facility aims to achieve and maintain a zero central line-associated bloodstream infection (CLABSI) rate. Infections can be costly for institutions of any size and are often not covered by health insurance. The interventions put in place in this quality improvement project were implemented in 4 phases: (1) develop a new standard of care for central lines and give nurses full responsibility for the care and handling of these lines (including blood sampling); (2) revise policy and provide educational sessions to support nurses; (3) document compliance with the new policy; and (4) document CLABSI rates. The project took place during a 15-month period between January 1, 2016 and March 30, 2017, in 4 critical care units in a university medical center in Lebanon. The results revealed a reduction in CLABSI rates from a maximum rate of more than 17 per 1000 catheter days to zero per 1000 catheter days, which was sustained for 10 months. Nurse compliance with the new policy after 3 months ranged from 95% to 99%.

摘要

每个医疗保健机构都旨在实现并维持零中心静脉导管相关血流感染（CLABSI）率。感染对任何规模的机构来说成本都很高，而且往往不在医疗保险覆盖范围内。在这个质量改进项目中实施的干预措施分四个阶段进行：（1）制定中心静脉导管的新护理标准，并让护士全面负责这些导管的护理和操作（包括采血）；（2）修订政策并提供教育课程以支持护士；（3）记录对新政策的遵守情况；（4）记录CLABSI率。该项目于2016年1月1日至2017年3月30日的15个月期间，在黎巴嫩一所大学医学中心的4个重症监护病房开展。结果显示，CLABSI率从每1000导管日超过17例的最高水平降至每1000导管日零例，并持续了10个月。3个月后护士对新政策的遵守率在95%至99%之间。