投稿分類 感控監測

主委發表種類: 壁報

投稿標題(中): 以中心導管組合式感染管制措施改善加護病房病人之臨床預後

投稿標題(英): Improvement of clinical outcomes in intensive care units patients after implementation of central venous catheter insertion and care bundle

投稿摘要: BACKGROUND
Central venous catheter (CVC) has been widely used, especially in intensive care units. Many institutions have recommended a set of interventions to lower down the rate of possible complications of CVC. The CVC care bundle is implemented in 2013 in our hospital to reduce the possible complications and extra-cost.

OBJECTIVE
We introduced CVC insertion and care bundle in our intensive care units and the outcome is evaluated.

METHOD
Patients admitted to ICUs during 1 March, 2012 to 31 May,2013 were enrolled as baseline groups as those admitted to ICU during 1 March, 2013 to 31 May,2013 were enrolled as intervention counterparts. A CVC insertion bundle was implemented in 1 February 2013.The clinical characteristic and outcome of the 2 groups are recorded and compared.

RESULT
In intervention period, CRBSI decreased in MICU and CCU, from 1.82% to 1.23% and from 5.56% to 3.70%, respectively. Duration of CVC device use declined in all ICUs as well (from 10.09 days to 9.96 days in RICU, from 10.60 days to 8.84 days in MICU, from 11.22 days to 8.74 days in CCU, and from 10.65 days to 8.38 days in SICU). The decrease of ICU stay ( up to 4.25 days) and total medical cost (up to 113182 New Taiwan dollars) were also noted in all ICUs, except in RICU.

DISCUSSION
CVC care bundle can decrease the CVC duration, ICU stay and total medical cost. The short observation periods and limited enrolled patient numbers may explain the statistical insignificancy.

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