頁籤選單縮合
題 名 | 加護中心住院病患使用相關導管引起的院內感染調查=Investigation of the Nosocomial Catheter-or Device-Associated Infections in the Intensive Care Unit |
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作 者 | 林金絲; 黃忠智; 許詩典; 饒淳英; 樊美知; 葉玉蓉; | 書刊名 | 院內感染控制雜誌 |
卷 期 | 11:1 2001.02[民90.02] |
頁 次 | 頁1-11 |
分類號 | 419.38 |
關鍵詞 | 加護中心; 院內感染; 導管暨裝置相關感染; Intensive care unit; Nosocomial infection; Catheter and device-associated infection; |
語 文 | 中文(Chinese) |
中文摘要 | 加護中心的病患由於時常接受侵入性的醫療措施,且病情較嚴重,成為院內感染之高危險群病人。為了暸解本院加護中心住院病人院內感染發生情形,特針對過去三年各類導管暨裝置所引起之院內感染的相關資料予以分析,以做為未來訂定院內感染相關管制措施及政策之重要參考依據。根據美國疾病管制中心1988年版之定義予以收案。結果從 1997 年至1999年,本院加護中心出院病人共計 1,884 人次,感染人次 229 ,院內感染發生率為為 12.7%。若以住院人日數(9,549)當分母,則院內感染發生密度為24.0?。過去三年,院內感染發生率和發生密度均呈下降趨勢,各類導管暨裝置的使用率亦有逐年減少的現象,如:導尿管、血管內裝置和呼吸器裝置之使用率,均從1997年之85.2%、50.8%和62.3%,分別降到 1999 年之68.3%、43.0%和56.1%。經單向變異分析結果,僅導尿管的使用率下降具統計學上顯著差異(F值=11.39,p<0.001)。但是由各類導管暨裝置所造成的院內感染發生密度卻是逐年上昇,特別是由導尿管所引起的泌尿道感染及血管內裝置所引起的血流感染,則從1997年之7.9? 和6.7?,分別上昇至 1999 年9.7? 和9.2? 。經t檢定分析,有置放各類導管暨裝置的病患其院內感染之發生密度是比無置放者所引起的院內感染發生密度顯著高出許多(p<0.05)。有鑑於上述導管暨裝置感染率均比國內外同性質之加護中心的感染率來得高,因此,感管人員有必要針對各類導管暨裝置之使用訂定標準操作程序,並透過定期的單位持續在職教育訓練和實地查核,促使醫護人員確實遵循各項標準操作流程及嚴格執行有效的管制措施,期盼將各類導管暨裝置所引起的院內感染率降至合理範圍。(感控雜誌2001;11:1-11) |
英文摘要 | Patients in the intensive care unit (ICU) are at a high risk of developing nosocomial infections. This is due to the severity of the patients'illnesses, increased virulence of the bacteria in the ICU, and the exposure of these patients to various life-saving invasive procedures. We retrospectively analyzed records of those with nosocomial infections in the medical/surgical ICU at our hospital from 1997 till 1999. Cases were collected according to the definitions set up by the US Centers for Disease Control and Prevention and published in 1988. There was a total of 1,884 discharged cases reviewed, of which 229 acquired nosocomial infection. The incidence rate was 12.7%, and the incidence density was 24.0?. For the past three years, both incidence rate and density decreased yearly. The utility rates for each catheter and device also declined; for Foley catheter, intravascular device, and ventilator, from 85.2%, 50.8% and 62.3%, respectively, in 1997, down to 68.3%, 43.0% and 56.1% in 1999, respectively. There is a statistical difference in utility rate of the Foley catheter by one way ANOVA (F value : 11.39, p<0.001). However, the incidence densities for each catheter-or device-associated infection increased annually; from 7.9? and 6.7?, respectively, for the catheter- associated urinary tract infection and the intravascular device-associated blood stream infection in 1997, up to 9.7? and 9.2?o in 1999, respectively. Our incidence density for the catheter-associated infection is higher than those reported by other ICUs. We have intensified the adherence of the personnel to the guidelines and standard operating procedures for all invasive procedures, and in-service training and education programs. (Nosocom Infect Control d 2001;11:1-11) |
本系統中英文摘要資訊取自各篇刊載內容。