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題名:重症病人導管相關血流感染的預防與照護
書刊名:護理雜誌
作者:盧淑芬陳季涵尚婉明周幸生
作者(外文):Lu, Shu-fenChen, Ji-hanShang, Wan-mingChou, Shin-shang
出版日期:2012
卷期:59:4
頁次:頁5-11
主題關鍵詞:重症病人中心靜脈導管導管相關血流感染群組護理critically ill patientscentral venous cathetercatheter-associated bloodstream infectionCare bundles
原始連結:連回原系統網址new window
相關次數:
  • 被引用次數被引用次數:期刊(8) 博士論文(0) 專書(0) 專書論文(0)
  • 排除自我引用排除自我引用:8
  • 共同引用共同引用:0
  • 點閱點閱:23
中心靜脈導管與導管相關血流感染的發生息息相關。重症病人一旦發生血流感染,其後果堪慮,不僅會延長住院天數、增加住院費用,甚而影響疾病預後。因此,加護單位護理人員須審慎面對,以確保病人安全。本文目的為探討重症病人導管相關血流感染預防策略及照護措施之最新趨勢。根據美國疾病管制局(Centers for Disease Control, CDC)於 2011年更新之照護指引內容及美國健康照護促進機構(the institute for healthcare improvement, IHI)所提倡實證照護模組項目,其中包含洗手、最大消毒範圍、使用 Chlorhexidine皮膚消毒、選擇注射部位、導管維護、注射部位護理及評估導管留置之必要性等項目,為預防中心靜脈導管相關血流感染重要且具成效的措施。同時,也建議機構可根據單位特性、可使用之資源及具實證之重要措施組成照護模組,並透過教育訓練等方式推展進行,同時利用稽核及監測來確保臨床照護人員確實遵循並持之以恆,方能有效預防中心靜脈導管相關血流感染,提升護理品質,也朝零容忍感染目標前進,達病人安全之里程碑。
Catheter-related bloodstream infections are associated with significantly increased morbidity, mortality, and expenditures. Such infections are a serious threat to patient safety in the intensive care unit. This review describes the latest protocols related to preventing and treating central venous catheter-associated bloodstream infections in critically ill patients. According to 2011 Center for Disease Control (CDC) guidelines and central line care bundles by the institute for healthcare improvement (IHI), prevention measures for catheter-related bloodstream infections include the following: hand hygiene, maximal barrier precautions insertion, chlorhexidine skin antisepsis, optimal catheter site selection, proper catheter maintenance, insertion site care, and daily review of line necessity, with prompt removal of unnecessary lines. These are important and effective infection prevention measures. Guidelines and care bundles also recommend organizing care modules based on unit characteristics; integrating resources and empirical measures; education and training to promote comprehensive implementation; and auditing and monitoring to ensure staff continue to follow procedures. Effectively preventing central venous catheter-related bloodstream infections can enhance care quality and move healthcare closer to achieving the goal of zero tolerance.
期刊論文
1.Kim, J. S.、Holtom, P.、Vigen, C.(2011)。Reduction of catheter-related bloodstream infections through the use of a central venous line bundle: Epideminologic and economic consequences。American Journal of Infection Control,39(8),640-646。  new window
2.Pronovost, P.、Needham, D.、Berenholtz, S.、Sinopoli, D.、Chu, H.、Cosgrove, S.、Sexton, B.、Hyzy, R.、Welsh, R.、Roth, G.、Bander, J.、Kepros, J.、Goeschel, C.(2006)。An intervention to decrease catheter-related bloodstream infections in the ICU。The New England Journal of Medicine,355(26),2725-2732。  new window
其他
1.疾病管制局(200910)。侵入性醫療裝置相關感染監測定義。  延伸查詢new window
2.Apisarnthanarak, A., Thongphubeth, K., Yuekyen, C., Warren, D. K., & Fraser, V. J.(2010)。Effectiveness of a catheter-associated bloodstream infection bundle in a Thai tertiary care center: A 3-year study。  new window
3.Furuya, E. Y., Dick, A., Perencevich, E. N., Pogorzelska, M., Goldmann, D., & Stone, P. W.(2011)。Central line bundle implementation in US intensive care units and impact on bloodstream infections。  new window
4.Galpern, D., Guerrero, A., Tu, A., Fahoum, B., & Wise, L.(2008)。Effectiveness of a central line bundle campaign on line-associated infections in the intensive care unit. Surgery。  new window
5.Garnacho-Montero, J., Aldabo-Pallas, T., Palomar-Martinez, M., Valles, J., Almirante, B., Garces, R., ... Ortiz-Leyba, C.(2008)。Risk factors and prognosis of catheter-related bloodstream infection in critically ill patients: A multicenter study。  new window
6.Guerin, K., Wagner, J., Rains, K., & Bessesen, M.(2010)。Reduction in central line-associated bloodstream infections by implementation of a postinsertion care bundle。  new window
7.Institute for Healthcare Improvement(2008)。5 million lives campaign: Prevent central line infections。  new window
8.Klevens, R. M., Edwards, J. R., Richards, C. L., Jr., Horan, T. C., Gaynes, R. P., Pollock, D. A., & Cardo, D. M.(2007)。Estimating health care-associated infections and deaths in U.S. hospitals, 2002。  new window
9.Marschall, J., Mermel, L. A., Classen, D., Arias, K. M., Podgorny, K., Anderson, D. J., ... Yokoe, D. S.(2008)。Strategies to prevent central line-associated bloodstream infections in acute care hospitals。  new window
10.McLaws, M. L., & Burrell, A. R.(2012)。Zero risk for central line-associated bloodstream infection: Are we there yet?。  new window
11.O’Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O., ... Saint, S.(2011)。Guidelines for the prevention of intravascular catheter-related infections。  new window
12.Ramritu, P., Halton, K., Cook, D., Whitby, M., & Graves, N.(2008)。Catheter-related bloodstream infections in intensive care units: A systematic review with meta-analysis。  new window
13.Safdar, N., & Abad, C.(2008)。Educational interventions for prevention of healthcare-associated infection: A systematic review。  new window
14.Shiung, T. F., Lu, S. F., & Chou, S. S.(201110)。Central line-associated bloodstream infection reduction by applying an integrated evidence-based care bundles in critically ill patients。  new window
15.Shuman, E. K., Washer, L. L., Arndt, J. L., Zalewski, C. A., Hyzy, R. C., Napolitano, L. M., & Chenoweth, C. E.(2010)。Analysis of central line-associated bloodstream infections in the intensive care unit after implementation of central line bundles。  new window
16.Stone, P. W., Pogorzelska, M., Kunches, L., & Hirschhorn, L. R.(2008)。Hospital staffing and health care-associated infections: A systematic review of the literature。  new window
17.Venkatram, S., Rachmale, S., & Kanna, B.(2010)。Study of device use adjusted rates in health care-associated infections after implementation of “bundles” in a closed-model medical intensive care unit。  new window
18.Zingg, W., Imhof, A., Maggiorini, M., Stocker, R., Keller, E., & Ruef, C.(2009)。Impact of a prevention strategy targeting hand hygiene and catheter care on the incidence of catheter-related bloodstream infections。  new window
 
 
 
 
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