icu导管相关感染监测

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1、SurveillanceofDeviceRelatedInfectioninIntensiveCareUnitICU导管相关感染监测(Aversionfortrainingpurposeonly,thedatainvolvedisnotreflectingtherealsituation)NationalNosocomialInfectionsSurveillance(NNIS)system全国院内感染监测系统Purpose目的Monitortheinfectionrates监控感染率Ben

2、chmarkwithNNISSystem与NNIS标竿Determinetrends确定趋势Identifyoutbreak定义暴发Facilitatecomparisons易于比较Linkmonitoredratesandpreventionefforts感染率与预防效果的联系Reducedevicesrelatedinfectioninhospital减少医院导管等装置的感染率Populationatrisk危险人群AllpatientshasbeenadmittedinICUfor>48h

3、ours.入ICU48小时的病人Followpatientsfor48hoursafterdischargefromICU.病人转出ICU需继续跟踪48小时Device-associatedinfections导管相关感染Urinarycatheter-associatedUrinarytractinfection(CA-UTI)导尿管相关的尿路感染Centralline-associatedBloodstreaminfection(CA-BSI)中心静脉导管相关的血流感染Ventilator-

4、associatedPneumonia(VAP)呼吸机相关的肺炎Denominatordata分母资料Countat12midnightineveryday每天在午夜12点计算Totalnumberofpatients’admission所有病人Patient-days病人日Urinarycatheter-days导尿管日Centralline-days中心静脉插管日Ventilator-days呼吸机日Surveillancemethods调查方法ongoingrevieweachpatien

5、tinICU.持续观察ICU的每个病人byreviewingDoctorsprogressnotes,Nursingnotes,Physiotherapistsnotes,XRreport,charts,MARforms,conversationswithnursesandphysicians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byreviewinglaboratorydata.查看实验室数据Definedevice-relatedinfection定义导管相关

6、感染ByusingstandardCDCdefinitionsthatincludelaboratory&clinicaldata使用CDC的标准包括实验室和临床资料Definitions–VAPHaddevicewithin48-hrsperiodbeforeonsetofinfectionSystemicS/SRespiratoryS/SChestX-RevidenceLaboratoryresultsDefinitions–CA-BSIHaddevicewithin48-hrsperiod

7、beforeonsetofinfectionClinicalmanifestationsCommonskincontaminantfrom2bloodculturesNoapparentsourceforBSIexceptthecatheterDefinitions–CA-UTISymptomaticUTIS/SofUTI+veurineculture>=10Asymptomaticbacteriuria+veurineculture>=10NoS/SofUTI55CalculateDevice

8、-associatedinfectionratesNumberofdevice-associatedinfectionforaspecificsitex1000Numberofdevice-daysCalculateDeviceutilizationratiosNumberofdevice-daysNumberofpatient-daysVAPSurveillanceinICUABNo.ofVAP627Patientdays13734872Ventilatordays6432694Infecti