從院內感染談病人安全與醫療照護品質

Patient's Safety and Healthcare Quality: Perspectives from In-Hospital Infection Control

王淑惠(Shu-Hui Wang)

《重症醫學雜誌》 8卷4期 (2007/12) Pp. 166-174

https://doi.org/10.30035/TCCM.200712.0003

摘要

控制院內感染是確保病人安全醫療品質的重要指標之一。2003年春，煞病襲捲台灣，喚醒醫療人員和健康照護機構，落實院內感染控制的觀念在民眾日常生活中的急迫性。
5~15%的住院患者會發生院內感染，其中有25~33%的患者會因併發症而住進加護病房。院內感染是可經以下方式儘量避免的：(1)擬訂感染控制計劃，降低院內感染發生率；(2)有效處置嚴重敗血症及器官失調衰竭等併發症。適切的擬訂感染控制計劃和指引及適當的抗生素處方是降低院內感染重要的策略，另方面良好的處置院內感染可能併發的嚴重敗血症，落實戰勝敗血症處置指引是另一新策略。
此篇文章，我們將討論院內感染的定義、防範和提醒，同時探討併發嚴重敗血症之處置。

關鍵字

院內感染 ； 醫療品質 ； 病人安全 ； 敗血症

並列摘要

Nosocomial infections (NIs) control is an important indicator of medical quality assurance to ensure patients' safety. In spring 2003, severe acute respiratory syndrome (SARS) attacked Taiwan, and physicians and health care organizations finally had the awareness that it is critical and emergent to implement the concepts of nosocomial infection control into people's daily life.
NIs now concern 5~15% of hospitalized patients and can lead to complications in 25 to 33% of those patients admitted to intensive care units. NIs is preventable through infection control programs by two strategies: one is to reduce NIs incidence and the other is to manage the nosocomial infection complicated with severe sepsis and organ dysfunction. Adequate management protocols and guidelines of the infection control and antibiotics prescription are crucial to reduce NIs. Furthermore, to get a better management of nosocomial infection complicated with severe sepsis, implementation of the Surviving Sepsis Campaign management guideline into clinical practice is a new way of strategy.
In this article, we discuss the definition of nosocomial infection, the prevention and precaution of NIs, and also the management of NIs complicated with severe sepsis.

並列關鍵字

Nosocomial infection ； Healthcare quality ； Patient safety ； Sepsis