最新ICU-导管相关感染调查教学讲义PPT课件.ppt

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1、ICU-导管相关感染调查NationalNosocomialInfectionsSurveillance(NNIS)system全国院内感染监测系统Purpose目的Monitortheinfectionrates监控感染率BenchmarkwithNNISSystem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Reducedevicesrelatedinfectioninhospi

2、tal减少医院导管等装置的感染率Surveillancemethods调查方法ongoingrevieweachpatientinICU.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-r

3、elatedinfection定义导管相关感染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-hrsperiodbeforeonsetofinfecti

4、onClinicalmanifestationsCommonskincontaminantfrom2bloodculturesNoapparentsourceforBSIexceptthecatheterDefinitions–CA-UTISymptomaticUTIS/SofUTI+veurineculture>=10Asymptomaticbacteriuria+veurineculture>=10NoS/SofUTI55CalculateDevice-associatedinfectionratesNumberofdevice-associatedinfectionfo

5、raspecificsitex1000Numberofdevice-daysCalculateDeviceutilizationratiosNumberofdevice-daysNumberofpatient-daysVAPSurveillanceinICUABNo.ofVAP627Patientdays13734872Ventilatordays6432694Infectionrates9.33(>50)10.02(>50)DUratios0.47[50]0.55[75]()NNISdeviceassociatedinfectionpercentile[]NNISdevic

6、eutilizationpercentileCA-BSISurveillanceinICUABNo.ofCA-BSI08Patientdays13734872CVCdays4023216Infectionrates0(10)2.49(25)DUratios0.26[>10]0.66[50]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentileCA-UTISurveillanceinICUABNo.ofUTI2312Patientdays13734872UrinaryCathdays1

7、1484711Infectionrates20.03(>90)2.55(25)DUratios0.84[50]0.97[.90]()NNISdeviceassociatedinfectionpercentile[]NNISdeviceutilizationpercentilePathogensIsolated-VAPNo.ofinfection6No.ofisolate9GM-vemicroorganism66.6%Proteus,Pseudnmonas,Acinetobacter,Klebsiella