投稿分類 防護措施

主委發表種類: 口頭

投稿標題(中): 運用品管手法以Bundle care 介入降低加護病房中心導管相關血流感染密度

投稿標題(英): Using QCC for bundle care intervention in central line-associated bloodstream incidence in an ICU

投稿摘要: Bundle care for central line insertion and maintain is a very important issue for many hospital recently, and it is also an annual goal of CDC Taiwan. The five components of this bundle care are 1. Hand hygiene and aseptic technique, 2. Selection of catheters and sites, 3. Maximal sterile barrier precautions, 4. Skin preparation, 5. Daily review of line necessity. The incidence of central line-associated bloodstream infection(CLBSI) in our ICU in 2011 was 4.3‰, and the average data from other same level hospitals was 3.12‰. We use QCC method to introduce central-line bundle care to ICU. According to investigation and group discussion results, we developed 3 strategies, 1. Set up check-list, 2. Education, training and promotion, 3. Improve our equipments, routine check and feedback to the staff. The infection density during 2012 July to September was down to 1.48‰. Though it surged up again to 9.41‰, but after we modified our maximal sterile barrier and skin preparation policy, it went down to 3.36‰ again; and the average admission day in our ICU also decrease from 34 days to 25 days. The bundle care for central-line insertion and care are effective to reduce the infection rate in ICU, and it will also decrease the length of hospitalization.

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