医院获得性感染的预防：更新指南

医院获得性感染的预防：更新指南

2014年12月21日⁄指南导读,

Prevention of Healthcare-Associated Infections: Updated Guidance

Laura A. Stokowski, RN, MS

Reviewed by: Deborah S. Yokoe, MD, MPH

December 10, 2014

From MEDSCAPE website

2008年，美国健康卫生流行病学会(Society for Healthcare Epidemiology of America, SHEA)与其合作者美国感染性疾病学会，美国医院协会，感染控制和流行病学专业协会以及联合委员会共同发布了有关预防医院获得性感染(HAI)循证策略的综合概要。2014年，对这一概要进行了更新，以反映HAI预防领域的最新证据。

In 2008, the Society for Healthcare Epidemiology of America (SHEA) published a comprehensive compendium of evidence-based strategies to prevent healthcare-associated infections (HAIs) with its partners, the Infectious Diseases Society of America, the American Hospital Association, the Association for Professionals in Infection Control and Epidemiology, and the Joint Commission.[1] In 2014, this compendium was updated to reflect new evidence in the field of HAI prevention.[2]

本套幻灯片总结了有关预防HAI的基本和最新策略的推荐意见，为一线医疗工作者(HCP)提供参考。全部概要针对各种HAI分为不同章节，并有单独一章讨论手卫生。

This slideshow provides the highlights of recommended basic and advanced strategies to prevent HAIs, and are aimed at frontline healthcare personnel (HCP). The complete compendium,

divided into separate chapters on each HAI with an additional chapter on hand hygiene, is available here.

概要全文涉及预防策略、行为指标、监测、报告、实施策略、干预实例的细节，以及不予推荐的措施。

Full-text chapters provide further details on prevention strategies, performance measures, surveillance, reporting, implementation strategies, and examples of interventions and approaches that are not recommended.

Images from CDC/Alamy/Science Source

导管相关性泌尿系感染

Catheter-Associated Urinary Tract Infection (CAUTI)

CAUTI最主要的危险因素是尿管(UC)留置时间。为减少UC过度应用：

The chief risk factor for CAUTI is the duration that a urinary catheter (UC) remains in situ. To reduce overuse of UCs:

▪明确本单位使用UC的适应症

▪Develop facility indications for use of UCs;

▪教育HCP有关替代UC的其他措施；以及

▪Educate HCP about alternatives to UCs; and

▪仅在必要时置入UC，且仅当有适应症时继续保留

▪Insert UCs only when necessary, and leave in only as long as indications remain.

Read SHEA's 2014 CAUTI prevention update.

Image from Dreamstime

CAUTI的预防

CAUTI Prevention

基本措施

The basics:

▪采用严格无菌操作技术，使用无菌物品（手套，隔离衣，海绵，消毒剂，润滑剂）

▪Use strict aseptic insertion technique with sterile supplies (gloves, drapes, sponges, disinfectant, lubricant);

▪采用无菌密闭引流系统

▪Maintain a sterile closed drainage system;

▪固定UC及管路防止牵拉

▪Secure UC and tubing to prevent traction;

▪确保尿液引流通畅

▪Maintain unobstructed urine flow;

▪常规进行手卫生

▪Use routine hand hygiene;

▪如果发生污染、脱开或渗漏，更换UC和尿液收集系统；且

▪Replace the UC and collection system if contaminated, disconnected, or leaking; and ▪采用无菌技术从无针头留样口或引流袋留取标本