预防CCU内导管相关性血流感染集束化管理的应用研究

Study on the application of cluster management for prevention of catheter related bloodstream infection in CCU

目的:探讨CCU内导管相关性血流感染集束化管理的实践应用。方法:依据中央导管相关性血流感染(CLABSI)的预防策略,研究制定CCU内导管相关血流感染(CRBSI)的集束化管理预防标准,指导并培训CCU内工作人员,实施CRBSI预防标准,进行追溯监测及质量管理。结果:实施CRBSI预防标准后,工作人员的手卫生依从性显著改善,手消毒液的使用量显著提高。置管时穿无菌隔离衣的依从率显著提高。患者置管后导管的使用率显著下降。置管期间及拔管后48 h内导管感染率显著下降。结论:CCU内实施CRBSI集束化管理对策能有效预防CRBSI。

Objective:To explore the application of cluster management for prevention of catheter related bloodstream infection in CCU.Methods:Based on the prevention strategy of central catheter associated bloodstream infection(CLABSI),we formulated the cluster management and prevention standard for catheter related bloodstream infection(CRBSI) in CCU;we guided and trained the staff in CCU,implemented CRBSI prevention standards,and carried out retrospective monitoring and quality management.Results:After the implementation of CRBSI prevention standards,hand hygiene compliance of staff was significantly improved;the use amount of hand disinfection solution was significantly improved.The compliance rate of wearing sterile isolation clothing at indwelling catheter was significantly improved.The use rate of the catheter after indwelling catheter of patients was significantly decreased.Catheter infection rate was significantly decreased during intubation and within 48 hours after extubation.Conclusion:In the CCU,the implementation of CRBSI cluster management strategy can effectively prevent CRBSI.