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本帖最后由 感控雏鹰 于 2018-6-3 16:20 编辑
看来超声探头处理的问题在美国也是问题啊 背景 与超声探头使用有关的不正确的感染预防实践与增加感染风险,暴发和死亡有关。尽管关于重新处理和使用探针的指导原则已经存在,但不清楚这些指南在实践中被广泛采用的程度。 方法 来自美国卫生保健机构的感染防控专家进行了调查(N = 358)。匿名调查有31个多项选择,滑动比例和文字回答问题。调查的开发和部署以及数据存储在REDCap系统中。 结果 高度不执行美国指南的情况被确定。被用于侵入性手术中使用的表面探头未执行高水平消毒或无菌的为15%(术中)至78%(外周线置入)。在侵入性手术中,5%-47%未使用无菌凝胶(分别采用相同的程序)。在参与者中,20%的人意识到在哪些地方使用超声探头但没有正确重新处理的情况。广泛违反感染控制指南被不断报道。超声的迅速扩大使用带来了临床效益,但可能会使患者面临可预防的感染风险。 结论 感染防控专家可以根据其在设施和卫生系统感染风险管理方面的专业知识和经验,充当主要的变化驱动因素。他们以及负责探头使用和再处理的临床医生应该在他们的设施中检查与超声有关的实践。如果实践不符合指南,应更新政策和培训以确保患者安全。
超声波和多普勒探头在整个卫生保健机构中使用。调查部门的受访者表示是否使用了超声波和多普勒探头。数据从大到小排序(放射科:n = 335; OB / GYN / MFM:n = 296;急诊:n = 305;心脏科:n = 254;手术室:n = 319; ICU [成人]: n = 275;血管/静脉诊所:n = 173;乳房诊所:n = 191;外科单位:n = 281; ICU [儿科]:n = 110;麻醉科:n = 297;矫形科:n = 266; n = 203;神经系统:n = 187;烧伤:n = 45;物理疗法:n = 206)。ICU,重症监护室; OB / GYN / MFM,产科/妇科/母亲胎儿医学。
超声探头重新处理依从性。A图为CDC、AIUM和AAMI对重新处理和使用的推荐做法。B图为相关依从性 Ultrasound probe use and reprocessing: Results from a national survey among U.S. infection preventionists Background Improper infection prevention practice associated with ultrasound probe use has been linked to increased infection risk, outbreaks, and death. Although guidelines for reprocessing and use of probes exist, it is unclear how extensively these have been adopted in practice. Methods Infection preventionists from U.S. health care facilities were surveyed (N?=?358). The anonymous survey had 31 multiple choice, sliding scale, and text response questions. The survey was developed and deployed and the data were stored in the REDCap system. Results A high degree of noncompliance with U.S. guidelines was identified. Surface probes used in invasive procedures were not high-level disinfected or sterilized 15% (intraoperative) to 78% (peripheral line placements) of the time. Of invasive procedures, 5%-47% did not use sterile gel (same procedures, respectively). Of the participants, 20% were aware of instances where an ultrasound probe was used but was not correctly reprocessed. Extensive breaches of infection control guidelines were reported. The rapid expansion in use of ultrasound has brought clinical benefit but may be exposing patients to preventable infection risk. Conclusions Infection preventionists are well placed to act as major drivers of change based on their expertise and experience in the management of infection risk across facilities and health systems. They, along with clinicians responsible for probe use and reprocessing, should review practices relating to ultrasound in their facilities. Where practice does not comply with guidelines, policy and training should be updated to ensure patient safety. 原文:DOI: https://doi.org/10.1016/j.ajic.2018.03.025 简译人:感控雏鹰
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