Reducing post-caesarean surgical wound infection rate: an improvement project in a Norwegian maternity clinic
Reducing post-caesarean surgical wound infection rate: an improvement project in a Norwegian maternity clinic
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DOI：
10.1136/bmjqs-2011-000316
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发表时间：
2012-03-01
影响因子：
5.4
通讯作者：
Walberg, Mette
中科院分区：
文献类型：
--
作者：
Dyrkorn, Ole A.;Kristoffersen, Marit;Walberg, Mette
背景：2006年至2007年，Baerum医院剖宫产手术伤口感染率为17.4%。目的：目的是将发病率降低到挪威国家水平8%以下。设计：干预（质量改进项目）于2008年9月实施。提出了一系列措施。从病人流程的各个方面招募工作人员。Cochrane文献被用作金标准。数据登记依据CDC标准。结果基于通过挪威国家卫生保健感染监测系统（NOIS）收集的数据。研究环境：这家产科诊所每年约有2500名新生儿，剖宫产率高达15%。患者组：研究对象为NOIS（2008-2010）登记的剖宫产患者。从2009年9月开始连续收集数据。评估：以累积发病率监测数据，并通过统计过程控制以g图（感染之间的手术次数，包括延迟移动平均）进行监测。感染控制人员每月向产科门诊主任报告结果。结果：剖宫产术中切口感染总体发生率明显降低至3.1%（2008-2010年约为1%）。这一结果在g图中被优雅地展示为过程中的显著变化。我们发现g图高效、灵敏且易于操作。
Background: During 2006 and 2007 the rate of caesarean section surgical wound infection was 17,4 % in Baerum Hospital.Objective: The objective was to reduce the incidence to below the Norwegian national level of 8 %.Design: The intervention (a quality improvement project) was implemented in September 2008. A bundle of measures were introduced. Staff from all aspects of patient flow was recruited. Cochrane literature was used as gold standard. Data registration was based upon CDC criteria. Results were based on data collected through the Norwegian national surveillance system for infections in health care, NOIS.Study setting: This Maternity clinic has about 2500 births annually and a caesarean section rate pushing 15 %.Patient group: The study was conducted on caesarean section patients registered in NOIS (2008-2010). From September 2009 data were harvested continuously.Assessment: Data were monitored as cumulative incidence rate and by statistical process control as g chart (number of surgeries between infections including a delayed moving average). Infection control staff reported results to Head of Maternity Clinic monthly.Results: The overall rate of caesarean section surgical wound infections was significantly reduced to 3,1 % (2008-2010 about 1 % in 2010). This result was demonstrated elegantly as a marked shift in process in g-chart. We found the g-chart was efficient, sensitive and simple to handle.