(Jarvis教授)保护患者及医护人员的安全.pptVIP

* * Impact of Closed Intravenous Systems on Patient Outcomes 密闭式静脉系统对患者结局的影响 OBJECTIVE: To compare the clinical impact and cost-effectiveness of using split septum needleless connectors (SS) + single-use prefilled flushing devices (SUF) vs. three-way stopcocks (3WSC) + multiple use container (MUC) on the incidence rate of central line-associated bloodstream infection (CLA-BSI). 目的：比较以下两种组合在中心导管相关性血流感染（CLA-BSI）发生率方面的临床意义和成本效益：分隔膜无针接头（SS） + 一次性预充冲洗装置（SUF）与三通（3WSC） + 多用途液袋（MUC）。 STUDY DESIGN: 5 intensive care units (ICUs) in two cities in India. Randomized clinical trial (RCT); clinical and cost effectiveness analysis.研究设计：印度两个城市的5个重症监护病房（ICU）。随机临床试验（RCT）；临床和成本效益分析。 PATIENT GROUPS: 1,096 adult ICU patients who needed a central line were block randomized.患者组：将1096名需要中心导管的成年ICU患者进行随机化分组。 Patients using SS+SUF (closed IV system)使用SS+SUF的患者（密闭式静脉系统) Patients using 3WSC + MUC (open IV system)使用3WSC + MUC的患者 (开放式静脉系统) Patients recruited between April 2012 and August 2014; 9,937 bed-days; 7,680 central line days (CLDs) 2012年4月至2014年8月招募的患者；9937床天；7680中心导管天数（CLD） OUTCOMES:结果： CLA-BSI rates: 2.21 per 1,000 CL-days (SS + SUF) vs. 6.40 per 1,000 CL-days (3WSC + MUC); p=0.006. CLA-BSI发生率：2.21/1000 CL天（SS + SUF）与6.40/1000 CL天（3WSC + MUC）；p=0.006。 Savings on patient cost from using SS+SUF:$402.88使用SS+SUF节省费用：$402.88 CONCLUSION: Introduction of a closed system (SS + SUF) significantly reduced CLA-BSIs and saved money结论：引入密闭式系统（SS + SUF）显著降低了CLA-BSI，且节省费用。 * * Conclusions结论： Catheter-related infections (CRIs) are a problem worldwide.导管相关感染（CRI）是全球性的问题。 Insertion and maintenance bundles can significantly reduce/prevent CRIs.置管和维护措施集可显著减少/预防CRI。 Healthcare worker safety also is a global issue.医护人员的安全性也是全球性的问题。 Needlestick injuries are a healthcare worker safety hazard which can be significantly reduced through the adoption of needless and safety-engineered devices, such as safety-engineered IV catheters and needleless connectors针刺伤是医护人员安全危害，可通过采用无针和安全设计设备（例如安全设计IV导管和无针接头）来显著减