- 學位論文
醫院內感染肺炎監測系統之建置
Develop a Surveillance System for Hospital-Acquired Pneumonia
摘要
院內感染是指病人在住院過程中發生的感染。依據美國CDC 2009年收案標準，其中主要感染部位為泌尿道感染、血液感染、呼吸道感染與手術部位感染等4大類。呼吸道感染為加護病房病人最常見的感染部位，其中又以肺炎最具代表性，其所導致的臨床徵狀極為嚴重且致死率高。院內感染監測著重於蒐集病人相關感染資料、進行分析與追蹤。過去大多數醫院因資源不足，導致在院內監測工作執行上難以全面且有系統地主動進行。近年來由於醫院紛紛推行電子病歷，並可以有效的支援日常的臨床作業。本研究將整合醫院現有電子病歷的優勢，建置一院內感染肺炎監測系統。本系統架構以服務導向架構開放式設計為基礎將醫院異質系統進行有效地連結、主動地蒐集病人資料並進行自動彙整，可以提供即時且詳盡的病人監測資訊，並協助院感人員進行日常院感作業之監測，以節省資料蒐集時間並有效提昇整體院內感染監測效率。
並列摘要
Healthcare-associated infections (HAIs) are infections that patients acquire during the course of receiving treatment for other conditions within a healthcare setting. The CDC’s guidelines classify healthcare-associated infections (HAIs) into four major types: urinary tract infection (UTI), surgical-site infection (SSI), blood stream infection (BSI), and respiratory tract infection (RTI). The respiratory tract infection that reported in intensive care unit (ICU) of patients is the most common type of HAI. Pneumonia is representative of RTI and can be an important cause of morbidity and mortality in ICU patients. HAI surveillance is a systematic, ongoing data collection, analysis and reporting process that require frequent, repeated and detailed bedside assessment on a patient by patient basis. In the past, it is time-consuming and costly, and therefore, HAI surveillance in many hospitals couldn’t regularly be performed. Nowadays, most hospitals in Taiwan have adopted electronic medical records (EMRs) to support day-to-day clinical practice. In this study, we have taken advantage of integration of EMRs of a hospital, and establish a hospital-acquired pneumonia surveillance information system based on a service-oriented architecture (SOA) technology. In the system design, the SOA technology was used for integration of the surveillance data, which are distributed in the different hospital information systems. The system architecture is flexible, and can support various levels of computerized workflows for HAI surveillance. As a result, the system can provide comprehensive data of patients for infection control professionals and support their daily surveillance tasks more responsively and efficiently.