降低某加護病房多重抗藥性鮑氏不動桿菌感染率成效專案

多重抗藥性鮑氏不動桿菌（MDRAB）是院內感染常見菌株，一旦感染易造成菌血症甚至死亡。本專案旨在降低MDRAB的感染率，統計本單位2013年第四季MDRAB感染率達1.34%，分析原因：醫護人員MDRAB隔離防護認知正確率僅62.9%、工作人員MDRAB隔離防護完整率低（醫護人員MDRAB隔離防護完整率僅51.9%、清潔人員MDRAB隔離防護完整率僅66.7%）、缺乏隔離提示系統、缺乏明顯的隔離標示。研擬對策：固定加護病房輪替的清潔人員、規劃教育訓練、增設「隔離通知訊息」、規劃病室隔離照護區、製作接觸隔離卡。實施後感染率由1.34%降至0.28%，醫護人員MDRAB隔離防護認知正確率提升至100%、醫護人員MDRAB隔離防護完整率提升至97.8%、清潔人員MDRAB隔離防護完整率提升至94.4%，顯示本專案有顯著效益。

關鍵字

鮑氏不動桿菌；多重抗藥性；感染

並列摘要

Multi-drug resistant Acinetobacter baumannii (MDRAB) is the common cause of nosocomial infections and can easily induce consequent bacteremia or mortality. This project aimed to lower the infection rate of MDRAB. The infection rate of MDRAB in this unit was 1.34% throughout the 4th quarter, 2013, which the following reasons: (1) the medical staffs had only 62.9% of accurate awareness of protective isolation; (2) the completeness of isolation protecting the operators was low (51.9% for medical staffs and 66.7% for cleaners); (3) the lack of alerting system for the implementation of isolation; and (4) there was no clear sign illustrating contact prohibition to control access for the involved staffs. The following approaches were then determined for improvement. First, some employees were assigned to the dedicated shift for cleaning. Second, implementation of training programs as planned. Third, a system releasing isolation notification alerts was established. Fourth, the isolation-caring area was dedicated in the ward. Finally, isolation-illustrating tags were prepared and tagged. After the implementation of these approaches, the infection rate of MDRAB was decreased to 0.28% from 1.34%, the accurate awareness of protective isolation among medical staffs was achieved to 100%, and the completeness of isolation protecting the operators was raised to 97.8% for medical staffs and 94.4% for cleaners, respectively. These result indicated the dramatic effectiveness of this project.

並列關鍵字

Acinetobacter baumannii ； multi-drug resistant ； infection

國際替代計量

降低某加護病房多重抗藥性鮑氏不動桿菌感染率成效專案

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