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干预措施对急性护理环境中手术部位感染发生率的影响:系统评价。

The effect of interventions on the incidence of surgical site infections in acute care settings: A systematic review.

机构信息

South/South West Hospitals Group, Department of Nursing and Midwifery, Erinville, Western Road, Cork, Ireland; Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland.

Catherine McAuley School of Nursing and Midwifery, College of Medicine and Health, University College Cork, Cork, Ireland.

出版信息

J Tissue Viability. 2024 Feb;33(1):75-88. doi: 10.1016/j.jtv.2023.11.004. Epub 2023 Nov 13.

Abstract

AIM

Surgical site infections (SSIs) are common healthcare associated infections with serious consequences for patients and healthcare organisations. It is critical that healthcare professionals implement prevention strategies to reduce the incidence of such infections. Prevention strategies are key to reducing the incidence of SSIs. The aim of this systematic review is to describe the effect of interventions conducted in acute care settings on the incidence of SSIs (primary outcome), length of stay, intensive care unit admission, and mortality rate (secondary outcomes).

MATERIALS AND METHODS

This review is reported using the Preferred Reporting Items for Systematic review and Meta-Analysis checklist. A search was undertaken in Academic Search Complete, CINAHL, ERIC, MEDLINE, PsycARTICLES, PsycINFO and Web of Science for studies published between January 2017 and March 2022. Studies that focused on interventions within acute hospital settings in patients undergoing elective surgery with the aim of reducing the incidences of SSIs were included. Due to heterogeneity results were synthesised narratively.

RESULTS

In total, 23 studies were included. Findings show that interventions that are effective in reducing the incidences of SSIs have multiple components including care bundles, stakeholder engagement, targeted surveillance and education. Few studies were identified that evaluated the effect of SSI prevention interventions on length of stay and mortality, and none assessed intensive care admission rates.

CONCLUSIONS

The included interventions varied widely, which made it difficult to draw definitive conclusions regarding specific interventions that reduce SSI. Multicomponent interventions and care bundles showed promise in reducing the occurrence of SSIs. Further studies should focus on standardised evidence-based interventions and compliance using randomised controlled designs.

摘要

目的

手术部位感染(SSI)是一种常见的与医疗保健相关的感染,会对患者和医疗保健机构造成严重后果。医疗保健专业人员必须实施预防策略,以降低此类感染的发生率。预防策略是降低 SSI 发生率的关键。本系统评价旨在描述在急性护理环境中实施的干预措施对 SSI 发生率(主要结局)、住院时间、重症监护病房入院率和死亡率(次要结局)的影响。

材料和方法

本综述按照系统评价和荟萃分析报告的首选报告项目清单进行报告。在 Academic Search Complete、CINAHL、ERIC、MEDLINE、PsycARTICLES、PsycINFO 和 Web of Science 中进行了检索,以检索 2017 年 1 月至 2022 年 3 月期间发表的研究。纳入的研究重点是在接受择期手术的急性医院环境中实施的干预措施,旨在降低 SSI 发生率。由于异质性,结果以叙述性方式综合。

结果

共纳入 23 项研究。研究结果表明,能够有效降低 SSI 发生率的干预措施具有多种组成部分,包括护理包、利益相关者参与、有针对性的监测和教育。确定的研究很少评估 SSI 预防干预措施对住院时间和死亡率的影响,也没有研究评估重症监护入院率。

结论

纳入的干预措施差异很大,因此很难就降低 SSI 的具体干预措施得出明确结论。多组分干预措施和护理包在降低 SSI 发生方面显示出一定的前景。进一步的研究应侧重于使用随机对照设计的标准化基于证据的干预措施和合规性。

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