ICU导管相关感染监测PPT.pptx

Surveillance ofDevice Related Infection in Intensive Care Unit ICU导管相关感染监测 (A version for training purpose only, the data involved is not reflecting the real situation )National Nosocomial Infections Surveillance (NNIS) system全国院内感染监测系统Purpose目的Monitor the infection rates 监控感染率Benchmark with NNIS System 与NNIS标竿Determine trends 确定趋势Identify outbreak 定义暴发Facilitate comparisons 易于比较Link monitored rates and prevention efforts 感染率与预防效果的联系Reduce devices related infection in hospital 减少医院导管等装置的感染率Population at risk 危险人群 All patients has been admitted in ICU for 48 hours. 入ICU48小时的病人Follow patients for 48 hours after discharge from ICU. 病人转出ICU 需继续跟踪48小时Surveillance methods 调查方法on going review each patient in ICU. 持续观察ICU的每个病人by reviewing Doctors progress notes, Nursing notes, Physiotherapists notes, XR report, charts, MAR forms, conversations with nurses and physicians 查看医生病程、护理记录、理疗单、X线检查、CT/MAR。医生护士的会话by reviewing laboratory data. 查看实验室数据 Define device-related infection 定义导管相关感染By using standard CDC definitions that include laboratory clinical data使用CDC的标准包括实验室和临床资料Definitions – VAPHad device within 48-hrs period before onset of infection Systemic S/SRespiratory S/SChest X-R evidenceLaboratory resultsDefinitions – CA-BSI Had device within 48-hrs period before onset of infectionClinical manifestationsCommon skin contaminant from 2 blood culturesNo apparent source for BSI except the catheterDefinitions – CA-UTI Symptomatic UTIS/S of UTI+ve urine culture =10Asymptomatic bacteriuria+ve urine culture =10No S/S of UTI55Calculate Device-associated infection ratesNumber of device-associatedinfection for a specific site x 1000Number of device-daysCalculate Device utilization ratios Number of device-daysNumber of patient-daysVAP Surveillance in ICU A BNo. of VAP 6 27Patient days 1373 4872Ventilator days 643 2694Infection rates 9.33 (50) 10.02 (50)DU ratios 0.47 [50] 0.55 [75]() NNIS device associated infection percentile[ ] NNIS device utilization percentileCA-B