醫療照護相關泌尿道感染的預防與組合式照護.ppt

2015 APSIC (The 7th?International Congress of theAsia Pacific Society of Infection Control) Thank you Each episode of SUTI costs additional $676; bacteremia: $2836 * Most microorganisms causing endemic CAUTI derive from the patients own colonic and perineal flora or from the hands of health-care personnel during catheter insertion or manipulation of the collection system. Organisms gain access in one of two ways (Figure 1). Extraluminal contamination may occur early, by direct inoculation when the catheter is inserted, or later, by organisms ascending from the perineum by capillary action in the thin mucous film contiguous to the external catheter surface. Intraluminal contamination occurs by reflux of microorganisms gaining access to the catheter lumen from failure of closed drainage or contamination of urine in the collection bag. Recent studies suggest that CAUTIs most frequently stem from microorganisms gaining access to the bladder extraluminally, but both routes are important (Table 2) (16). Some studies suggest that the extraluminal route may be of greater relative importance in women because of the short urethra and its close proximity to the anus (17). Investigators have found that antecedent heavy periurethral cutaneous colonization is an important risk factor for CAUTI in both men and women (17,18). * * * * * * * * Summary 本計畫自6月份完成議價簽約之後，即組成專案小組，針對介入措施行細節進行討論，並依專案小組決議，展開教育訓練、建立「中心導管置放查檢表」、「中心導管每日照護評估表」與工作手冊各項相關工具、以及收集基礎值資料等準備工作，並自100年11月起正式進入介入措施執行階段。 將14家參與醫院26間加護病房的中心導管相關血流感染密度分為在介入前(2010/1~2011/10)與介入後(2011/11~2012/05)比較，整體降低幅度達17.1% 。 整體計畫執行成效仍須待後續資料收集完整後，再行分析評估。 WHO Surgery Safety Checklist Urinary Catheter Care Bundle Insertion and Management Clostridium difficile care bundle Ventilator assisted Pneumonia care bundle Palliative care bundle Pressure area care bundle Sepsis care bundle PVC care Bundle Antibiotic care bundle Types of Care Bundles Urinary Tract Infections CDC：Guidelines for Prevention of Catheter-Associated Urinary Tract