综合护理包教育项目对急诊重症监护病房设备相关感染的影响。
Impact of a comprehensive care bundle educational program on device-associated infections in an emergency intensive care unit.
作者信息
Negm Essamedin M, Othman Howaydah A, Tawfeek Mohamed M, Zalat Marwa M, El-Sokkary Rehab H, Alanwer Khaled M
机构信息
Dr, PhD, Anesthesia & Surgical Intensive Care Department, Faculty of Medicine, Zagazig University, Zagazig, PO: 44519, Egypt.
PhD, Prof. Anesthesia & Surgical Intensive Care Department, Faculty of Medicine, Zagazig University, Zagazig, PO: 44519, Egypt.
出版信息
Germs. 2021 Sep 29;11(3):381-390. doi: 10.18683/germs.2021.1275. eCollection 2021 Sep.
INTRODUCTION
Implementation of care bundles was shown to reduce the incidence of device-associated infections (DAIs). Substantial improvements in the rate of infection have been achieved by applying educational programs for infection control. Objectives: To demonstrate the impact of a comprehensive care bundle educational program (CCBEP) on DAIs, mortality rates in an emergency Intensive Care Unit (ICU), and improving healthcare workers (HCWs') knowledge, compliance to care bundle, and infection control practice.
METHODS
A quasi-experimental study was carried out in an 15-beds emergency ICU, from May 2017 to October 2018. A comprehensive care bundle educational program was implemented. It covers items regarding device care bundle and infection control.
RESULTS
Device care bundle compliance was variable between different bundle items. There was a significant improvement in HCWs' knowledge after the educational program intervention especially in hand hygiene, catheter-associated urinary tract infection (CAUTI) bundle, and total knowledge. There was a higher risk of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLABSI), and CAUTI in the pre-intervention phase compared to post-intervention (RR: 1.4, 1.4, and 1.9 respectively). The total mortality rate decreased from 24.2/100 to 16.7/100 patients after intervention.
CONCLUSIONS
There was a statistically significant improvement in compliance with device care bundles with a decrease in the incidence of DAIs.
引言
护理集束化措施的实施已被证明可降低器械相关感染（DAIs）的发生率。通过实施感染控制教育项目，感染率已得到显著改善。目的：证明综合护理集束化教育项目（CCBEP）对急诊重症监护病房（ICU）的器械相关感染、死亡率的影响，以及提高医护人员（HCWs）的知识水平、对护理集束的依从性和感染控制实践。
方法
2017年5月至2018年10月，在一家拥有15张床位的急诊ICU进行了一项准实验研究。实施了一项综合护理集束化教育项目。该项目涵盖了与器械护理集束和感染控制相关的内容。
结果
不同护理集束项目之间的器械护理集束依从性存在差异。教育项目干预后，医护人员的知识水平有显著提高，尤其是在手部卫生、导尿管相关尿路感染（CAUTI）集束和总体知识方面。与干预后相比，干预前呼吸机相关性肺炎（VAP）、中心静脉导管相关血流感染（CLABSI）和CAUTI的风险更高（相对风险分别为1.4、1.4和1.9）。干预后患者的总死亡率从24.2/100降至16.7/100。
结论
器械护理集束的依从性有统计学意义的提高，器械相关感染的发生率降低。
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