美国APIC主席撰文——建设一个面向明天的感染预防控制体系：2007年APIC工作回顾和总结

David

American Journal of Infection Control
Volume 36, Issue 4, May 2008, Pages 232-240  

Special article
Building the infection prevention system of tomorrow: Proceedings of the 2007 APIC Futures Summit
建设一个面向明天的感染预防控制体系：2007年APIC工作回顾和总结
Denise Murphy BSN, MPH, CICa, , , Ruth Carrico PhD, RN, CICb and Kathy Waryec

aBarnes Jewish Hospital, St. Louis, Missouri

bSchool of Public Health and Information Sciences, Center for Health Hazards Preparedness, University of Louisville, Louisville, Kentucky

cAssociation for Professionals in Infection Control and Epidemiology, Inc, Washington, DC


Available online 30 April 2008.

Article Outline（提纲）
Introduction and background引言和背景
Complex adaptive systems复杂的适应性系统
Complex adaptive systems in support of targeting zero health care–associated infections复杂适应性系统的目标是医院感染零宽容
Be guided by a few simple rules一些简单的需要遵守的规则
Keep the emphasis on learning at the most local level possible尽最大可能学习学习再学习
Develop a “good enough” design改善一个足够好的设计
The current state of infection prevention感控目前的状态
Getting to zero: envisioning an ideal future state of infection prevention达到零：可以预见得到的一个理想的感染控制的未来
Simple rules for an infection prevention system适用于感控系统的简单的规则
The infection prevention learning system感控学习系统
Essential design elements of an infection prevention system感控系统的关键模块
Closing the gap: engineering the ideal future state减小缝隙：设计制造一个理想的未来
Guiding principles and simple rules: Attributes of the ideal infection prevention system用于理想感控系统的指导原则和简单法则
Robust learning systems at the level of those doing the work 强有力的在职学习系统
A “good enough” system design 设计一个足够好的系统
The infection control professional of tomorrow: knowledge, skills, and attributes 明天的感控专业人员：知识、技能和品质
Conclusion and next steps结论和下一步工作打算
Acknowledgements 感谢
References参考文献

Introduction and background
In November 2004, work began toward creating a vision for the future of the Association for Professionals in Infection Control and Epidemiology (APIC), recognizing that the field of infection prevention and control is clearly part of a wave of change. Out of that first “Futures Summit” came the APIC 2012 Strategic Planning and Vision document, aimed at providing clarity of purpose and guidance. This document links activities and resources to the APIC's vision and guiding principles.

Together with key partners, APIC has continued to address the dynamic and complex current state and future of infection prevention. In February 2006, the second Futures Summit, addressing the economics of health care-associated infections (HAIs), resulted in a white paper aimed at dispelling myths about the financial impact of HAIs. The assumption that infections resulting from health care delivery are cost-neutral has been challenged by programs demonstrating that HAI prevention saves both lives and dollars. The white paper was published by APIC in partnership with the Health Care Financial Managers Association and was made available on both associations' websites in March 2007.1

The 2007 Futures Summit, Building the Model Infection Prevention System of Tomorrow, brought together experts in infection prevention and control to design an ideal future state and a system for infection prevention. Despite the fact that we have made significant strides in reducing HAIs, still about 100,000 persons per year die from this adverse outcome. In fact, Klevens et al2 evaluating data from 2002, reported that HAI was the number-one notifiable disease, and that deaths associated with HAI in hospitals exceeded the numbers attributed to several of the top-10 causes of death in the United States. We believe that we can create a safer system in which patients can receive care in diverse health care settings without the threat of acquiring an infection.

Using a process that functioned much as a “think tank,” we worked to dispel doubts that anything can happen—even getting to zero HAIs. Summit activities included graphic facilitation, environmental scanning, identification of challenging trends, creative problem-solving strategies, and early development of action plans. Using visual facilitation, the group members' thoughts and comments were sketched out on paper to bring ideas and connections to life.

The 2007 Futures Summit “think tank” comprised participants invited because of the unique point of view and perspective that they and/or their organizations bring to the future of infection prevention. Participants included technical and systems experts, academic and professional association collaborators, accreditors and industry partners, and APIC board members and key staff members. Support from these individuals and their organizations were critical to the success of the summit and the application of its outcomes. Open sharing among individuals and the collective wisdom resulted in new ideas and solutions to common problems.

The key challenge was to first conceptualize infection prevention and control as an organized system with all of the necessary components to ensure protection from harm, then to generate ideas, characteristics, and critical success factors to lay the framework on which to build a model system.

A “system” in general is defined as an integrated collection of facilities, parts, equipment, tools, materials, information technology, personnel, and/or techniques that compose an organized whole capable of performing or supporting some function.3 To help clarify the concept of infection prevention as a system, we can start with some assumptions, as follows:

• The health care system, the environment in which we strive to prevent infection, can be described as a complex, adaptive system.

• Within the (macro) system of health care, infection prevention is a component of a larger patient safety system designed to prevent any adverse outcome. Although with committed, visionary leadership, an infection prevention microsystem can be initiated regardless of the status of an organization's overall safety efforts, this may be more successful if part of a comprehensive protection system.

• All systems must be designed and intentionally engineered to produce a desired outcome consistently.

• The patient must be at the center of all we do, and the desired outcome of their care must be zero HAIs.

• We recognize that an infection prevention system must involve many disciplines and members of the health care team, not simply a professional trying to manage disparate prevention efforts in a solo state.

• An infection prevention system must be competency-driven, so our vision includes an articulation of those competencies needed to lead, manage, and participate in this safety system.

Clearly, achieving the target (elimination of HAIs) will depend on how effectively we influence others and build critical partnerships.

[ 本帖最后由 David 于 2008-5-3 23:11 编辑 ]

缭绕

（提纲）
引言和背景
复杂的适应性系统
复杂适应性系统的目标是医院感染零宽容
一些简单的需要遵守的规则
尽最大可能学习学习再学习
改善一个足够好的设计
感控目前的状态
达到零：可以预见得到的一个理想的感染控制的未来
适用于感控系统的简单的规则
感控学习系统
感控系统的关键模块
减小缝隙：设计制造一个理想的未来
用于理想感控系统的指导原则和简单法则
强有力的在职学习系统
设计一个足够好的系统
明天的感控专业人员：知识、技能和贡献
结论和下一步工作打算

学习，学习，学习！要做一个好的感控人员，就要不断地学习！

[ 本帖最后由 缭绕 于 2008-5-3 22:44 编辑 ]

桂花香

天的感控专业人员：知识、技能和贡献
只有不断学习，才能做好工作！