ProCon debate Are barrier precautions cost-effective in improving patient outcomes in the intensive care unit 英文参考文献.docVIP

Thampi and Morris Critical Care 2012,16:202 /content/16/1/202 RE VIE W Pro/Con debate: Are barrier precautions cost-e? ective in improving patient outcomes in the intensive care unit? Nisha Thampi and Andrew M Morris * 1 2 prophylaxis. Nonetheless, infectious diseases continue to challenge the quality of care provided in ICUs. Prompted by accreditation and patient-centered care, hospitals are challenged to provide high-quality care with ? nite ? nancial resources. Any new IPAC initiative will thus be examined for its cost-e? ectiveness. Abstract You are responsible for a large medical surgical ICU. Your hospital administration has been very focused on reducing rates of hospital-acquired infections particularly in the wake of increasing public attention. However, it is time for budget preparation and your ?nancial o?cer is concerned about the escalating costs associated with patient isolation and barrier precautions/personal protective equipment. Having become aware of the high costs associated with these interventions, you start to wonder about the wisdom of spending so much in this area. Your hospital administration wants your direction on next year’s expenditures. You are debating whether the expense is worthwhile and advise your hospital administration accordingly. e broad impact of infection control on rates of hospital-associated infections goes back more than 200 years. A 1795 treatise on puerperal fever by Alexander Gordon, who made seminal observations as an obste trician in the United Kingdom, suggested the illness was due to an infection, and recommended that healthcare workers (HCW) wash themselves and have their clothing fumigated after contact with these patients e eminent American physician Oliver Wendell Holmes also suggested that gowns worn by physicians during autopsies served