护理捆绑包对手术部位感染发生率的影响：系统评价。

The Impact of Care Bundles on the Incidence of Surgical Site Infections: A Systematic Review.

机构信息

At the Skin Wounds and Trauma Research Centre at the Royal College of Surgeons in Ireland, Dublin, Pinar Avsar, PhD, MSc, BSc, RGN, is Senior Postdoctoral Fellow; Declan Patton, PhD, MSc, PGDipEd, PGCRM, BNS(Hons), RNT, RPN, is Deputy Director and Director of Nursing and Midwifery Research; and Aicha Sayeh, PhD, is Postdoctoral Researcher. At the Institute of Skin Integrity and Infection Prevention, University of Huddersfield, West Yorkshire, England, Karen Ousey, PhD, RGN, FHEA, CMgr MCMI, is Professor and Director; Joanna Blackburn, PhD, MSc, BSc, is Research Fellow. Also at Royal College of Surgeons in Ireland, Tom O'Connor, EdD, MSc Ad Nursing, PG Dip Ed, BSc, Dip Nur, RNT, RGN, is Professor; and Zena Moore, PhD, MSc, FFNMRCSI, PG Dip, Dip First Line Management, RGN, is Professor, Head of the School of Nursing & Midwifery, and Director of the Skin Wounds and Trauma Research Centre. The authors have disclosed no financial relationships related to this article. Submitted July 7, 2021; accepted in revised form August 11, 2021.

出版信息

Adv Skin Wound Care. 2022 Jul 1;35(7):386-393. doi: 10.1097/01.ASW.0000831080.51977.0b.

DOI:10.1097/01.ASW.0000831080.51977.0b

PMID:35723958

Abstract

OBJECTIVE

This systematic review assesses the effects of care bundles on the incidence of surgical site infections (SSIs).

DATA SOURCES

The search was conducted between February and May 2021, using PubMed, CINAHL, SCOPUS, Cochrane, and EMBASE databases.

STUDY SELECTION

Studies were included if they used systematic review methodology, were in English, used a quantitative design, and explored the use of care bundles for SSI prevention. A total of 35 studies met the inclusion criteria, and 26 provided data conducive to meta-analysis.

DATA EXTRACTION

Data were extracted using a predesigned extraction tool, and analysis was undertaken using RevMan (Cochrane, London, UK). Quality appraisal was undertaken using evidence-based librarianship.

DATA SYNTHESIS

The mean sample size was 7,982 (median, 840) participants. There was a statistically significant difference in SSI incidence in favor of using a care bundle (SSI incidence 4%, 703/17,549 in the care bundle group vs 7%, 1,157/17,162 in the usual care group). The odds ratio was 0.55 (95% confidence interval, 0.41-0.73; P < .00001), suggesting that there is a 45% reduction in the odds of SSI development for the care bundle group. The mean validity score for all studies was 84% (SD, 0.04%).

CONCLUSIONS

The results indicate that implementing care bundles reduced SSI incidence. However, because there was clinically important variation in the composition of and compliance with care bundles, additional research with standardized care bundles is needed to confirm this finding.

摘要

目的

本系统评价评估了护理套餐对手术部位感染（SSI）发生率的影响。

资料来源

检索于 2021 年 2 月至 5 月，检索数据库包括 PubMed、CINAHL、SCOPUS、Cochrane 和 EMBASE。

研究选择

纳入使用系统评价方法、为英文、采用定量设计并探讨护理套餐预防 SSI 的研究。共有 35 项研究符合纳入标准，其中 26 项提供了有助于荟萃分析的数据。

资料提取

使用预先设计的提取工具提取资料，使用 RevMan（英国伦敦 Cochrane）进行分析。使用循证图书馆学进行质量评估。

资料综合

平均样本量为 7982 名（中位数为 840 名）参与者。使用护理套餐组的 SSI 发生率具有统计学显著差异（SSI 发生率为 4%，703/17549；常规护理组为 7%，1157/17162）。比值比为 0.55（95%置信区间，0.41-0.73；P<0.00001），表明护理套餐组 SSI 发生率降低 45%。所有研究的平均有效性评分均为 84%（标准差，0.04%）。