Kolbe-Busch Susanne, Chaberny Iris F
Institut für Hygiene, Krankenhaushygiene und Umweltmedizin, Zentrum für Infektionsmedizin, Universitätsklinikum Leipzig, Liebigstr. 22, 04103, Leipzig, Deutschland.
Chirurgie (Heidelb). 2023 Mar;94(3):220-229. doi: 10.1007/s00104-022-01784-8. Epub 2023 Jan 2.
Procedures to prevent surgical site infections require a high input of human, technical and natural resources. This paper explores ways to optimize the use of resources in caring for patients who undergo a surgical procedure without compromising patient safety.
Review of the contribution of selected procedures for infection prevention in surgical patients considering current evidence and recommendations by comparing current guidelines and results of clinical trials. Analysis of interventions to implement and increase compliance.
Knowledge of current evidence-based recommendations enables not only the identification of procedures with proven effect on infection prevention but also those that are ineffective and thus dispensable. There is still need for further controlled studies, e.g. on the use of antiseptics, that can confirm the evidence level of preventive procedures. Infection surveillance in combination with process and compliance monitoring by infection prevention specialists with a feedback system to healthcare workers are suitable control instruments for infection control management. In the case of increased infection rates, the implementation of evidence-based recommended measures through tailored bundle interventions is successful. Technical measures to maintain environmental conditions must be included in the control process.
The reduction of healthcare-associated infections by implementing tailored interventions of infection prevention measures and elimination of ineffective procedures conserves resources and promotes patient safety.
预防手术部位感染的措施需要大量人力、技术和自然资源投入。本文探讨在不影响患者安全的前提下，优化资源利用以护理接受外科手术患者的方法。
通过比较当前指南和临床试验结果，回顾所选预防手术患者感染措施的作用，考虑现有证据和建议。分析实施及提高依从性的干预措施。
了解当前基于证据的建议不仅能够识别对预防感染有 proven 效果的措施，还能识别无效因而可省去的措施。仍需进一步的对照研究，例如关于防腐剂使用的研究，以证实预防措施的证据级别。感染监测与感染预防专家进行的过程及依从性监测相结合，并向医护人员反馈，是感染控制管理的合适控制手段。在感染率上升的情况下，通过量身定制的集束干预措施实施基于证据的推荐措施是成功的。维持环境条件的技术措施必须纳入控制过程。
通过实施量身定制的感染预防措施干预并消除无效措施来减少医疗相关感染，可节省资源并促进患者安全。
