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坚持标准化的感染防控综合措施可降低结肠手术后手术部位感染率:一项针对526例患者的回顾性队列研究。

Adherence to a standardized infection reduction bundle decreases surgical site infections after colon surgery: a retrospective cohort study on 526 patients.

作者信息

Guerrero Marlon A, Anderson Brandie, Carr Gordon, Snyder Kara L, Boyle Patrick, Ugwu Sharon A, Davis Melissa, Bohnenkamp Susan K, Nfonsam Valentine, Riall Taylor S

机构信息

University of Arizona, Surgery, Arizona, Tucson, USA.

Banner University Medical Center, Tucson, Arizona, USA.

出版信息

Patient Saf Surg. 2021 Apr 8;15(1):15. doi: 10.1186/s13037-021-00285-7.

Abstract

BACKGROUND

Colon surgical site infections (SSI) are detrimental to patient safety and wellbeing. To achieve clinical excellence, our hospital set to improve patient safety for those undergoing colon surgery. Our goal was to implement a perioperative SSI prevention bundle for all colon surgeries to reduce colon surgery SSI rates.

METHODS

This retrospective cohort study evaluated the impact of implementing a perioperative SSI prevention bundle in patients undergoing colon surgery at Banner University Medical Center - Tucson. We compared SSI rates between the Pre- (1/1/2016 to 12/31/2016) and post-bundle (1/1/2017 to 12/31/2017) cohorts using a chi-square test.

RESULTS

In total, we included 526 consecutive patients undergoing colon surgery in our study cohort; 277 pre-bundle and 249 post-bundle implementation. The unadjusted SSI rates were 8.7 % and 1.2 %, pre- and post-bundle, respectively. Our CMS reportable standard infection rate decreased by 85.4 % from 3.08 to 0.45 after implementing our SSI prevention bundle.

CONCLUSIONS

Implementing a standardized colon SSI prevention bundle reduces the overall 30-day colon SSI rates and national standardized infection rates. We recommend implementing colon SSI reduction bundles to optimize patient safety and minimize colon surgical site infections.

摘要

背景

结肠手术部位感染(SSI)对患者的安全和健康有害。为实现卓越的临床效果,我院着手提高接受结肠手术患者的安全性。我们的目标是对所有结肠手术实施围手术期SSI预防综合措施,以降低结肠手术SSI发生率。

方法

这项回顾性队列研究评估了在图森班纳大学医学中心对接受结肠手术的患者实施围手术期SSI预防综合措施的影响。我们使用卡方检验比较了综合措施实施前(2016年1月1日至2016年12月31日)和实施后(2017年1月1日至2017年12月31日)队列的SSI发生率。

结果

我们的研究队列总共纳入了526例连续接受结肠手术的患者;综合措施实施前277例,实施后249例。综合措施实施前和实施后的未调整SSI发生率分别为8.7%和1.2%。实施SSI预防综合措施后,我们的医疗保险和医疗补助服务中心(CMS)可报告的标准感染率从3.08降至0.45,下降了85.4%。

结论

实施标准化的结肠SSI预防综合措施可降低30天结肠SSI总体发生率和国家标准化感染率。我们建议实施降低结肠SSI的综合措施,以优化患者安全并尽量减少结肠手术部位感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9ebc/8034065/0d7aebdd2015/13037_2021_285_Fig1_HTML.jpg

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