{"title":"整形手术中导管的使用和感染的减少。","authors":"Zach J Barnes, Raman C Mahabir","doi":"10.1177/229255031302100205","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infection and can result in increased health care costs, morbidity and even mortality. In 2009, The Scott & White Memorial Hospital/Texas A&M Health Science Center (Texas, USA) system's CAUTI rate placed it in the upper quartile (ie, highest rate) for the country, necessitating a system-wide change.</p><p><strong>Objective: </strong>To design and implement a guideline to reduce the incidence of CAUTI.</p><p><strong>Methods: </strong>A multidisciplinary team was formed and completed both a root cause analysis and a review of the available literature. Consolidating the best evidence, the team formulated a best practice guideline detailing the proper indications for insertion of, improper use of and techniques to minimize infection with catheters. Included as part of this protocol was nursing and patient education, changes in identifying patients with a catheter and automatic termination orders. Three-, six- and 12-month reviews identifying additional opportunities for improvement at the end of 2010 were completed.</p><p><strong>Results: </strong>In 2009, the hospital's CAUTI rate was 1.46 per 1000 catheter days. In 2011 - the first complete year of the finalized guideline - the hospital's CAUTI rate was 0.52 per 1000 catheter days, ranking the institution in the bottom quartile (ie, lowest rate) for the country. The surgery and plastic surgery subgroup analyses also demonstrated statistically significant reduction in both catheter use and CAUTI.</p><p><strong>Conclusion: </strong>The incidence of CAUTI was successfully reduced at The Texas A&M Healthcare Center. The guideline, its development and how it applies to plastic surgery patients are discussed.</p>","PeriodicalId":50714,"journal":{"name":"Plastic Surgery","volume":null,"pages":null},"PeriodicalIF":0.7000,"publicationDate":"2013-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/229255031302100205","citationCount":"5","resultStr":"{\"title\":\"Catheter use and infection reduction in plastic surgery.\",\"authors\":\"Zach J Barnes, Raman C Mahabir\",\"doi\":\"10.1177/229255031302100205\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infection and can result in increased health care costs, morbidity and even mortality. In 2009, The Scott & White Memorial Hospital/Texas A&M Health Science Center (Texas, USA) system's CAUTI rate placed it in the upper quartile (ie, highest rate) for the country, necessitating a system-wide change.</p><p><strong>Objective: </strong>To design and implement a guideline to reduce the incidence of CAUTI.</p><p><strong>Methods: </strong>A multidisciplinary team was formed and completed both a root cause analysis and a review of the available literature. Consolidating the best evidence, the team formulated a best practice guideline detailing the proper indications for insertion of, improper use of and techniques to minimize infection with catheters. Included as part of this protocol was nursing and patient education, changes in identifying patients with a catheter and automatic termination orders. Three-, six- and 12-month reviews identifying additional opportunities for improvement at the end of 2010 were completed.</p><p><strong>Results: </strong>In 2009, the hospital's CAUTI rate was 1.46 per 1000 catheter days. In 2011 - the first complete year of the finalized guideline - the hospital's CAUTI rate was 0.52 per 1000 catheter days, ranking the institution in the bottom quartile (ie, lowest rate) for the country. The surgery and plastic surgery subgroup analyses also demonstrated statistically significant reduction in both catheter use and CAUTI.</p><p><strong>Conclusion: </strong>The incidence of CAUTI was successfully reduced at The Texas A&M Healthcare Center. 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引用次数: 5
摘要
背景:导尿管相关性尿路感染(CAUTI)是最常见的医院相关感染,可导致医疗费用、发病率甚至死亡率增加。2009年,Scott & White纪念医院/Texas A&M Health Science Center (Texas, USA)系统的CAUTI比率在全国名列前茅(即最高比率),因此需要进行全系统的改革。目的:设计并实施降低CAUTI发生率的指南。方法:组成了一个多学科小组,完成了根本原因分析和对现有文献的回顾。为了巩固最佳证据,该团队制定了最佳实践指南,详细说明了导管插入的适当适应症、不当使用和技术,以尽量减少导管感染。作为该方案的一部分,包括护理和患者教育,识别导管患者的变化和自动终止命令。在2010年底完成了3个月、6个月和12个月的审查,确定了进一步改进的机会。结果:2009年该院CAUTI率为1.46 / 1000导管d。2011年,即指南最终定稿的第一年,该医院的CAUTI率为每1000个导管日0.52例,在全国排名垫底四分之一(即最低率)。手术和整形手术亚组分析也显示导管使用和CAUTI的统计学显著减少。结论:得克萨斯A&M医疗中心成功降低了CAUTI的发病率。本文讨论了该指南的发展及其在整形手术患者中的应用。
Catheter use and infection reduction in plastic surgery.
Background: Catheter-associated urinary tract infections (CAUTI) are the most common hospital-associated infection and can result in increased health care costs, morbidity and even mortality. In 2009, The Scott & White Memorial Hospital/Texas A&M Health Science Center (Texas, USA) system's CAUTI rate placed it in the upper quartile (ie, highest rate) for the country, necessitating a system-wide change.
Objective: To design and implement a guideline to reduce the incidence of CAUTI.
Methods: A multidisciplinary team was formed and completed both a root cause analysis and a review of the available literature. Consolidating the best evidence, the team formulated a best practice guideline detailing the proper indications for insertion of, improper use of and techniques to minimize infection with catheters. Included as part of this protocol was nursing and patient education, changes in identifying patients with a catheter and automatic termination orders. Three-, six- and 12-month reviews identifying additional opportunities for improvement at the end of 2010 were completed.
Results: In 2009, the hospital's CAUTI rate was 1.46 per 1000 catheter days. In 2011 - the first complete year of the finalized guideline - the hospital's CAUTI rate was 0.52 per 1000 catheter days, ranking the institution in the bottom quartile (ie, lowest rate) for the country. The surgery and plastic surgery subgroup analyses also demonstrated statistically significant reduction in both catheter use and CAUTI.
Conclusion: The incidence of CAUTI was successfully reduced at The Texas A&M Healthcare Center. The guideline, its development and how it applies to plastic surgery patients are discussed.
期刊介绍:
Plastic Surgery (Chirurgie Plastique) is the official journal of the Canadian Society of Plastic Surgeons, the Canadian Society for Aesthetic Plastic Surgery, Group for the Advancement of Microsurgery, and the Canadian Society for Surgery of the Hand. It serves as a major venue for Canadian research, society guidelines, and continuing medical education.