cla-bsi 课件.pptVIP

CLA-BSI: Update;Central Line Infections中心静脉感染;Terminology:术语CR-BSI (catheter related bloodstream infection)导管相关性血流感染CLA-BSI (Central line associated bloodstream infection)中心静脉导管相关性血流感染CA-BSI (Catheter associated bloodstream infection)导管相关性血流感染;Definition of a Central Line中心静脉导管定义;CLA-BSI: Definition (CDC)CDC指南CLA-BSI的定义;CR-BSI;Diagnosis: CR-BSI CR-BSI定义;“CLA-BSI surveillance definition may overestimate the true incidence of CR-BSI.”CLA-BSI的监控可能高估CR-BSI的真实发病率;Catheter InfectionsIncidence导管相关性感染的发病率; Blood stream Infection (14% HAI’s) - #3血流感染 Third most common hospital acquired infection (HAI)3个最常见的院内感染 #1 – Urinary Tract Infection (UTI) (34% HAI’s)尿路感染 #2 – Surgical Site Infections (SI) (17% HAI’s)手术部位感染 #4 – Ventilator Associated Pneumonia(VAP)(13% HAI’s)呼吸机相关性肺炎 ;ICU central-line infections drop dramatically nationwideICU中心静脉感染全国范围内下降;CDC Report CDC报道;CDC Rates CLA-BSI CLA-BSI发生率;The reduction in CLABSI incidence in 2009 compared with 2001 was greatest for Staphylococcus aureus CLABSIs (73% reduction; rate ration [RR] =0.27; 95% confidence interval [CI] =0.238—0.294)与2001年相比，2009年CLABSI发病率下降率最大的是由金黄色葡萄球菌引起的CLABSIs（减少73％;;Variables Affecting Evaluation of Infection Rates 变量影响感染率评价;Goal Rate CLA-BSI 目标CLA-BSI 零容忍;Cost of HAI HAI成本;Patient Payer Mix HAI’s (2006);Not Reimbursed (CMS)医保不覆盖（CMS）;Medicare: Reimbursement医疗保险;Published Cost CLA-BSI/CR-BSI成本计算;Strategies Reduce Infections减少感染的策略;Routes of contamination污染途径;Intraluminal route腔内途径 Extraluminal route腔外途径;Skin皮肤;Skin皮肤;Skin皮肤;CDC Definition of Category RecommendationsCDCD类别的定义;Hand Hygiene手卫生;Site Selection置管部位选择;Site Selection置管部位选择;Skin Preparation置管部位的准备;Ultrasound Guidance超声引导;Maximal Sterile Barrier Precautions最大无菌屏障;Max Barrier最大屏障;Replacement of emergency CVAD紧急更换中心静脉装置;Peripheral arterial catheters外周动脉导管;Chlorhexidine Impregnated Sponge洗必泰海绵;Antimicrobial/antiseptic impregnated catheters and cuffs带抗菌涂层的导管;Prevention: Maximal Barrier Precautions (MSB)预防：最大无菌屏障注意事项;Prevention CR-BS