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降低護理之家下呼吸道感染發生密度

The Reduction of the Incidence Density of Lower Respiratory Tract Infection in a Nursing Home

摘要


本機構發現2015年第一季下呼吸道感染發生密度驟增至千分之2.64,故成立專案小組,經由查閱實證文獻,及跨團隊整合感染管制專業人員的加入,建立機構的下呼吸道照護臨床指引,結合護理師及照服員的臨床經驗,創新設計「抽吸五時機」提醒標語加以推行,建立「下呼吸道感染照護技術標準作業規範」、「噴霧治療設備使用及維護作業規範」及拍攝「下呼吸道感染預防標準技術示範影片」,做為機構工作人員之臨床照護準則,經教育訓練和宣導及相關措施執行9個月後,提升了照服員的照護技術正確率和認知正確率,並有效降低下呼吸道感染發生密度由千分之2.64至千分之1.48,且凝聚了工作人員的向心力及團結精神,顯示本專案之措施能有效改善下呼吸道感染發生密度及提升機構住民照護品質。

並列摘要


Nursing home residents are usually associated with long-term illness, low immunity and use of multiple medications. Nursing aides who spend most of their time providing care for residents, and therefore their knowledge on infection control is very important for quality nursing home care. A study indicated that nursing home residents' hospitalization rate for pneumonia was 31%; the death rate was 8.8%; and pneumonia- related readmission rate was between 33.9% and 39.1%. The incidence density of lower respiratory tract infection in the institute involved in this project increased from 1.61% in 2014 to 2.64% in the first quarter of 2015. Through survey and analysis of causal relationships, the project team designed and implemented standards of care, a teaching video, and posters to improve nursing aides' knowledge and techniques on the care to prevent lower respiratory tract infection. The incidence density decreased to 1.48 % in the first quarter of 2016. The intervention strategies were effective in reducing lower respiratory tract infection and providing quality of care to residents.

參考文獻


林永捷、彭莉甯、陳亮恭(2011).長期照護機構住民的感染症.台灣老年醫學暨老年學雜誌 ,6(2),73-81。doi:10.29461/TGG.201105.0001
吳仁光、惠群(2013).護理之家肺炎的臨床特性.內科學誌,24,107-117。doi:10.6314/JIMT.2013.24(2).04
張珠玲、陳旭華(2015).護理之家感染管制的執行現況探討.感染控制雜誌,25(3),115-125。doi:10.6526/ICJ.2015.302
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