医院感染目标性监测译ppt课件

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1、医院感染的目标性监测TargetedSurveillanceforNosocomialInfectionsBarbaraM.Soule,RN,MPA,CICChineseSocietyforNosocomialInfectionsJuly4-5,2004Suzhou,ChinaICP的工作内容ICPractitioner(ICP)Activities监测Surveillance项目管理ProgramManagement教育Education工作的多样性Miscellaneous暴发调查OutbreakInvestigation咨询Consultation2监测应具有

2、流行病学基础SurveillancehasanEpidemiologicfoundation为了计划和实施干预措施，研究处于某特定感染危险的人群（目标人群）中的问题和事件的分布Studythedistributionofproblemsandeventswithinadefined(targeted)populationatriskfordevelopingspecificinfectionsinordertoplan&implementinterventions.33种主要的监测方法3KeySurveillanceMethods医院范围的传统监测Hospital-

3、wideTraditionalSurveillance所有的感染-全面-花费时间Allinfections–complete-timeconsuming有限的时间用于干预Limitstimeforinterventions定期监测PeriodicSurveillance对选择的感染或人群进行定期监测Selectedinfectionsorpopulationsperiodicallyovertime遗漏有些感染Misssomeinfections目标监测TargetedSurveillance4名称Name优点Advantages缺点Disadvantages目标性

4、监测Targeted/FocusedSurveillancebyObjective将有限的资源集中在高感染危险病区Concentrateslimitedresourcestohighriskareas;重点放在有已知控制措施的感染上FocusesonHAIwithknowncontrolmeasures;能够确定确切的分母Candeterminevaliddenominator;灵活性，能够和其他控制策略结合起来Flexible,canbemixedwithotherstrategies;增加监测的有效性Increasesefficiencyofsurveillan

5、ce;使ICP能够开展其他工作EnablesICPtoperformotheractivities仅能收集监测目标病人或危险的数据Collectsdataonlyfortargetedpatientsorrisks;漏掉未监测病区或病人的感染集聚或暴发Maymissclustersoroutbreaksinnon-surveyedareasorgroupsAdaptedfromPottingeretal&Gaynesetal.优/缺点Advantages/Disadvantages5目标性监测TargetedSurveillance美国CDC国家医院感染监测系统的目

6、标性监测CDC’sNationalNosocomialInfectionsSurveillance(NNIS)SystemTargets:NNISSystemAURICUHRNSurgicalPatientAntimicrobialUseandResistanceIntensiveCareUnit(Adult/Pediatric)HighRiskNursery(NICU)RiskadjustedSSIsbyProcedures7你所在医院监测系统的目标性监测YourHospitalSurveillanceSystemTargets:YourHospitalVAPIC

7、UBSISSIVentilator-AssociatedPneumoniaMedical/SurgicalICUsIntensiveCareUnit(Pediatric)PrimaryBloodStreamInfectionsPrimaryOrthopedicNeurosurgicalorCABGProcedures8哪些感染作为目标性监测Whichinfectiontotarget?重点为具有高感染危险的病人FocusonpatientsathighriskforHAI病人的护理病区Patientcareareas重症监护病房ICU’s,心胸外科cardio-