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目的通过对多中心重症监护病房(ICU)中心静脉导管相关血流感染(CLABSI)情况的调查,采取相应的控制与干预方法,以降低其感染率。方法 2015年4月-2015年9月对全军19家医院的22个ICU的患者进行基线调查作为干预前的资料;2015年9月对相关人员进行干预措施培训;2015年10月-2016年5月进行插管干预和维护干预方法作为干预后资料,对干预前后资料进行比较。结果干预前后中央静脉导管使用率,置管部位构成比,手卫生的依从性和正确率,皮肤消毒剂构成,每日评估并记录,使用无菌大铺巾、置管者着装合格、端口消毒合格率的比较,差异有统计学意义(P<0.05);干预前后CLABSI千日发病率比较,差异无统计学意义。结论插管干预组合和维护干预组合两者结合,提高中心静脉置管使用过程中的安全性,对降低CLABSI的发生还有待更进一步研究。
Objective To investigate the prevalence of central venous catheter-related bloodstream infections (ICA) in patients with intensive care unit (ICU) and to take appropriate control and intervention measures to reduce the infection rate. Methods From April 2015 to September 2015, baseline surveys were performed on 22 ICU patients in 19 hospitals in the PLA as pre-interventional data. Interventions were conducted for related personnel in September 2015; October 2015-2016 May intubation intervention and maintenance intervention methods as the post-intervention data, pre and post intervention data were compared. Results Before and after the intervention, the central venous catheter usage, the composition ratio of the catheter, the conformity and correctness of the hand hygiene and the composition of the skin disinfectant were evaluated and recorded daily. Sterile big towel, There was no significant difference in the incidence of CLABSI between the two groups before and after the intervention (P <0.05). Conclusion The combination of intubation and maintenance interventions can improve the safety of central venous catheterization. It is yet to be further studied to reduce the incidence of CLABSI.