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1、TargetedSurveillanceforNosocomialInfectionsBarbaraM.Soule,RN,MPA,CICChineseSocietyforNosocomialInfectionsJuly4-5,2004Suzhou,ChinaICPractitioner(ICP)ActivitiesSurveillanceProgramManagementEducationMiscellaneousOutbreakInvestigationConsultation2SurveillancehasanEp
2、idemiologicfoundationStudythedistributionofproblemsandeventswithinadefined(targeted)populationatriskfordevelopingspecificinfectionsinordertoplan&implementinterventions.33KeySurveillanceMethodsHospital-wideTraditionalSurveillanceAllinfections–complete-timeconsumi
3、ngLimitstimeforinterventionsPeriodicSurveillanceSelectedinfectionsorpopulationsperiodicallyovertimeMisssomeinfectionsTargetedSurveillance4Advantages/DisadvantagesAdaptedfromPottingeretal&Gaynesetal.5TargetedSurveillanceCDC’sNationalNosocomialInfectionsSurveillan
4、ce(NNIS)SystemTargets:NNISSystemAURICUHRNSurgicalPatientAntimicrobialUseandResistanceIntensiveCareUnit(Adult/Pediatric)HighRiskNursery(NICU)RiskadjustedSSIsbyProcedures7YourHospitalSurveillanceSystemTargets:YourHospitalVAPICUBSISSIVentilator-AssociatedPneumoniaM
5、edical/SurgicalICUsIntensiveCareUnit(Pediatric)PrimaryBloodStreamInfectionsPrimaryOrthopedicNeurosurgicalorCABGProcedures8Whichinfectiontotarget?FocusonpatientsathighriskforHAIPatientcareareasICU’s,cardio-thoracicsurgery,cancerwardSpecificpopulationsneonates,tra
6、nsplantpatients,hemodialysisptsProcedures/DevicesCTsurgery,centralvascularlines,ventilatorsOrganismsofepidemiologicimportance–MRSA,VRSA9TargetedSurveillanceforOutcomesPrimaryBloodstreaminfectionsVentilator-associatedpneumonia,SurgicalsiteinfectionsMRSA,VREinfect
7、ionsVascularaccessinfectionsinhemodialysispatientsSharpsinjuriesinhealthcareproviders.10TargetedSurveillanceforProcessesHepatitisBimmunityratesinpersonnelPersonnelcompliancewithprotocols-isolationprecautions,Sterilizationqualityassurancetesting,Effectiveenvironm
8、entalcleaningAntimicrobialprescribingandadministration11Howtoimplementtargetedsurveillance12StepOneICPandMDreviewMicrobiologyreportsdailyReviewpastsurveillancedataper
