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休越雷池一步
讓 HAI 新聞與資訊寄送到您的電子郵件信箱。
                                 
由 Kimberly-Clark 知識網路提供
                                   
Kimberly-Clark 提供 一系列的臨床解決方案,以因應促成呼吸器相關肺炎感染的危險因子,其中包括:


呼吸器相關肺炎(VAP) 是現今臨床醫師最關切的三大類感染之一,這類感染佔美國 1 所有醫療照護相關感染的死亡率可達 60%。其他的主要美國統計資料包括:

  • 約有 8-28% 的重症病患會感染呼吸器相關肺炎 2
  • 因醫療照護而感染肺炎的患者,死亡率為 20% 至 33% 1
  • 感染呼吸器相關肺炎會導致患者在加護病房(ICU)多待 4 至 6 天 1
  • 每起呼吸器相關肺炎病例估計增加 20,000 至 40,000 美元的成本 1

呼吸器相關肺炎是全球性的問題。 德國在 2001-2005 年期間,有 5.72% 的加護病房患者感染呼吸器相關肺炎。3  依據最近統計,法國有 9.2% 的患者在加護病房內感染肺炎。4  在英國,因住院而遭受呼吸道感染讓住院天數平均增加了 12 天,每位患者平均增加 4,149 美元的成本。5

美國疾病控制預防中心(CDC)的全國院內感染監測系統(National Nosocomial Infection Surveillance System,簡稱 NNIS)通報,在 2002 年,病患接受連續機械性換氣比未接受者高出 6 到 21 倍的院內感染肺炎風險。 因為如此高的風險,最近 20 多年來的院內感染肺炎研究都集中在呼吸器相關肺炎上。6

1.CDC. Guidelines for Preventing Healthcare-Associated Pneumonia, 2003. Recommendations of the CDC and the Healthcare Infection Control Practices Advisory Committee. MMWR 2004; 53 (No. RR-3).
2.Chastre J, Fagon J. Ventilator-associated pneumonia. Crit Care Med. 2002; 165:867-903.
3.資料來源:KISS Krankenhaus-Infektions-Surveillance-System。 Modul ITS-KISS。 http://www.nrz-hygiene.de/dwnld/ITS_reference_200512.pdf
4.資料來源:HELICS Implementation Phase II, Final Report, March 2005
5.The Socio-economic Burden of Hospital Acquired Infection. Executive Summary. Public Health Laboratory Service. 1999

6. http://www.cdc.gov/ncidod/dhqp/dpac_ventilate.html



臨床教育(推廣教育和醫學繼續教育)

更多臨床教育…

資源與工具
  • 照護人員呼吸器相關肺炎(VAP)最佳實務策略(學習指南)
  • 不可忽視口腔護理 (學習指南)
  • 透過詳細說明的盲目操作支氣管肺泡灌洗術(Mini-BAL)以診斷 VAP 之策略(學習指南)
  • 臨床問題 #3:不可忽視口腔護理
  • 呼吸器相關肺炎:診斷、治療與預防
  • 美國疾病控制預防中心(CDC)手部衛生指引

    瞭解更多資源及工具…

    研究報告(僅提供英文版)
  • Lessons from the Pioneers Reporting Healthcare-Associated Infections (National Conference of State Legislatures)
         

    The National Conference of State Legislatures has released a new report that offers lessons on infection-reporting data from nine of the states that first required medical facilities to report health care-associated infections. The NCSL looked at state laws passed from 2005 to 2009 and interviewed state lawmakers, health care providers and other related groups in Alabama, Colorado, Delaware, Illinois, Massachusetts, New Hampshire, Oregon, Pennsylvania and Washington. Since 2005, the number of states that require health care facilities to report HAIs has jumped from six to 27.

    Download PDF
  • Probiotic Prophylaxis of Ventilator-associated Pneumonia: A Blinded, Randomized, Controlled Trial (Respiratory and Critical Care Medicine)
         

    Lee E. Morrow of Creighton University and colleagues have discovered that cases of ventilator-associated pneumonia in critically ill patients in hospitals were cut in half after patients were given probiotic bacteria. The study involved 138 critically ill patients from a single hospital, who were either given placebo or the probiotic Lactobacillus rhamnosus. Donald Craven of the Lahey Clinic Medical Center in Burlington, Mass., said the results "hold promise for trying to prevent an infection that has serious morbidity, mortality and is a major factor for hospital costs that we’re trying to contain."

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  • Hospital-Acquired Infections Due to Gram-Negative Bacteria (New England Journal of Medicine)
         

    The New England Journal of Medicine published findings from researchers at Massachusetts General Hospital that suggested gram-negative bacteria play a significant role in about 30 percent of hospital-acquired infections in the U.S. The findings showed that such bacteria were the predominant players in 47 percent of ventilator-associated pneumonia cases and 45 percent of urinary tract infections. The researchers noted that almost any gram-negative bacteria can cause bloodstream infection if an adequate portal of entry is present.

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  • 研究:常見的氣囊過度充氣(麻醉學新聞,Anesthesiology News)
         

    根據一位大力推動手術房器械例行控管的英國調查人員表示,手術進行中氣管插管的氣囊壓可能太高。

    The study, by anesthesiologists at University College London, found that endotracheal tube (ETT) cuff pressures averaged 41 cm H2O—16 cm H2O greater than the recommended maximum level of 25 cm H2O in the United Kingdom. Pressures that high could increase patients’ risk for sore throat, hoarseness and difficulty swallowing.

    阅读更多
  • 流行感冒∕傷風∕呼吸道病症通報(FAN)
         

     

    The weekly U.S. FAN Report includes:

     ·       全美國、成人與兒童年齡層疫情爆發的發病率追蹤

    ·        兒童三大爆發年齡層:0-2 歲、3-5 歲和 6-12 歲
    ·        市場涵蓋範圍代表全美國、九大人口普查區和 150 個主要市場
    ·        預測所有市場;每年提出 52 週報告
    ·        針對全國與九大人口普查區之全美國、成人和兒童群組症狀趨勢
    ·        Adult and 成人與兒童的症狀趨勢包括:div>
     
    - Cough                - Nasal Congestion          - Sore Throat
    - Ear Ache            - Fever                  - Influenza-Like-Illness (ILI)
     
    ·        Long range Projections for Calendar 4th QTR.
    ·        第一季與第二季之疾病預測
    ·        全美國、成人與兒童四週循環計畫
     

     

     

     

     

    Download Excel
  • 呼吸器相關肺炎帶來的臨床與後續經濟影響:系統性的檢視,作者:Safdar 醫師等
         
    阅读更多
  • Guidelines for Prevention, Diagnosis and Treatment of Ventilator-Associated Pneumonia (VAP) in the Trauma Patient
         Inflammation and the Host Response to Injury, a Large–Scale Collaborative Project: Patient–Oriented Research Core—Standard Operating Procedures for Clinical Care.
    阅读更多
  • 感染肺炎最新途徑:使用呼吸器 作者 - Jean Chastre 與 Jean-Yves Fagon
         
    Download PDF

    瞭解更多醫療照護相關感染的研究報告…
     
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