医院感染目标性监测译.ppt

医院感染的目标性监测Targeted Surveillance for Nosocomial Infections Barbara M. Soule, RN, MPA, CIC Chinese Society for Nosocomial Infections July 4-5, 2004 Suzhou, China ICP 的工作内容IC Practitioner (ICP) Activities 优/缺点Advantages/Disadvantages 目标性监测Targeted Surveillance 美国CDC国家医院感染监测系统的目标性监测CDC’s National Nosocomial Infections Surveillance (NNIS) System Targets: 你所在医院监测系统的目标性监测 Your Hospital Surveillance System Targets: 哪些感染作为目标性监测Which infection to target? 重点为具有高感染危险的病人Focus on patients at high risk for HAI 病人的护理病区Patient care areas 重症监护病房ICU’s, 心胸外科cardio-thoracic surgery, 癌症病房cancer ward 特殊人群Specific populations 新生儿neonates, 移植病人transplant patients, 血液透析病人hemodialysis pts 操作/设备Procedures / Devices CT 外科CT surgery, 中央静脉插管central vascular lines, 呼吸机ventilators 具有流行病学意义的病原体Organisms of epidemiologic importance – MRSA, VRSA 针对后果的目标性监测Targeted Surveillance for Outcomes 原发性血液系统感染 Primary Bloodstream infections 呼吸机相关性肺炎 Ventilator-associated pneumonia 手术部位感染 Surgical site infections MRSA, VRE infections 血液透析病人经血管的感染 Vascular access infections in hemodialysis patients 医疗机构中的锐器刺伤 Sharps injuries in healthcare providers 针对过程的目标性监测Targeted Surveillance for Processes 医务人员的乙肝免疫率 Hepatitis B immunity rates in personnel 医务人员对操作规则的依从性-隔离预防Personnel compliance with protocols - isolation precautions, 灭菌质量监测 Sterilization quality assurance testing, 有效地环境清洁 Effective environmental cleaning 抗微生物药物的使用与管理 Antimicrobial prescribing and administration 怎样实施目标性监测How to implement targeted surveillance 第一步 Step One 感染控制护士和医生每天查看微生物学报告 ICP and MD review Microbiology reports daily 定期查阅过去的监测数据 Review past surveillance data periodically 列出作为目标性监测的潜在感染或人群 Develop a list of the potential infections or populations for targeted surveillance 第二步 Step Two 感染控制人员基于以下一个或多个标准选择目标性监测的医院感染 Infection control team selects nosocomial infections to target based on one or more of the following criteria: 选择过程或后果进行目标监测的的标准Crit