ABSTRACT
Objective To investigate the incidence of surgical site infection(SSI)and compliance to bundle inter-vention measures on SSI following total abdominal hysterectomy in patients in department of gynaecology of a tertia-ry first-lass hospital,and evaluate the efficacy of bundle intervention measures in prevention and control of SSI. Methods From March 2014 to October 2015,all gynecology patients undergoing total abdominal hysterectomy were as targeted monitored subjects,March-September 2014 was baseline investigation stage,October 2014 to Oc-tober 2015 was intervention stage(new bundle intervention measures were performed),compliance to bundle inter-vention measures and incidence of SSI before and after intervention were compared.Results A total of 222 episodes of total abdominal hysterectomy were monitored,the incidence of SSI was 5 .86% ,the operation P75 time were 2 hours. Compared with the baseline stage,the compliance to most traditional intervention measures improved after intervention,the largest increase in the compliance to interventions was follow-up after surgery (increased by 64.16% ),followed by preoperative perineal disinfection(increased by 39.07% )and hand hygiene(increased by 21 .34% ). Compliance to new intervention measures was 100.00% . Incidence of SSI following total abdominal hys-terectomy after intervention was significantly lower than before intervention(2.27% [3/132]vs 11.11% [10/90]), difference was significant (χ2= 7.583,P<0.05).Conclusion Targeted monitoring on SSI following total abdomi-nal hysterectomy can improve compliance to bundle intervention measures and decrease incidence of SSI.
ABSTRACT
Objective To evaluate the effect of evidence-based bundle intervention strategy on reducing the inci-dence of central line-associated bloodstream infection (CLABSI).Methods Prospective and multicenter study was adopted,patients admitted to 54 intensive care units (ICUs)of 41 hospitals and with central venous catheters (CVCs)between October 1 ,2013 and September 30,2014 were monitored .Baseline data between October 2013 and March 2014 were collected as pre-intervention data;from April to September 2014,the participated hospitals performed intervention strategy,post-intervention data were compared with pre-intervention data.Results The usage rate of CVCs before and after intervention was significantly different (44.18% vs 44.63%,χ2 =5.526,P =0.019).Incidence of CLABSI before and after intervention was not significantly different(RR ,0.82[95%CI ,0.59-1 .13],P =0.10).Constituent ratio of catheter insertion sites between pre-and post-intervention was significantly different (χ2 =76.264,P <0.001),femoral vein catheterization rate as well as proportion of two and above catheter insertion sites after intervention decreased(17.25% VS 13.72%;2.27% VS 1 .44%,respectively);hand hygiene implementation rate and accuracy rate after intervention were both higher than before intervention (79.73% vs 76.14%,P <0.001 ;91 .47% vs 74.26%,P <0.001 ,respectively);constituent ratio of skin disinfectant applica-tion before and after intervention was significantly different(χ2 =3.861 ,P <0.001 ),proportion of chlorhexidine ethanol increased (29.62% VS 50.56%);except daily assessment and record,compliance to other prevention and control measures before and after intervention were all significantly different(all P <0.001);utilization rate of max-imal sterile barrier,qualified rate of dressing of operators,and port disinfection were all significantly enhanced. Conclusion Bundle intervention in intubation and maintenance are implemented effectively,but intervention effect on CLABSI needs further study.
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Objective To explore the effect of bundle hand hygiene intervention in controlling healthcare-associated infec-tion(HAI)in a primary comprehensive hospital,so as to improve hand hygiene compliance and correct rate,and reduce AHI rate. Methods In January-June 2014,bundle hand hygiene intervention among health care workers (HCWs)in a hospital was performed,hand hygiene knowledge awareness rate,hand hygiene compliance and correct rate,hand sanitizer usage and HAI rate before and after intervention were compared. Results After performing intervention for six months,the awareness rate of hand hygiene knowledge(concept,significance,indications,methods,sanitizer use)of HCWs improved com-pared with before intervention (P<0.05);hand hygiene compliance and correct rate were significantly higher than before inter-vention (77.92% vs 49.78% ;76.47% vs 37.72% )(P<0.05). Hand sanitizer usage increased from 2.14mL/bed-day to 4.63 mL/bed-day ,HAI rate decreased from 1.97% to 1.54% (P<0.05).Conclusion Bundle hand hygiene intervention can improve HCWs’knowledge awareness,compliance and execution rate of hand hygiene,and effectively reduce HAI rate.