Guidance on public reporting of healthcare-associated infections: Recommendations of the Healthcare Infection Control Practices Advisory Committee
Guidance on public reporting of healthcare-associated infections: Recommendations of the Healthcare Infection Control Practices Advisory Committee
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DOI：
10.1016/j.ajic.2005.04.001
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发表时间：
2005-05-01
影响因子：
4.9
通讯作者：
Brennan, PJ
中科院分区：
文献类型：
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作者：
McKibben, L;Horan, T;Brennan, PJ
自2002年以来，4个州已颁布立法，要求医疗保健机构公开披露医疗保健相关感染（HAI）率。其他几个州也在进行类似的立法工作。HAI强制性公开报告的倡导者认为，公开这些信息将使消费者能够对其医疗保健做出更明智的选择，并通过减少HAI来提高整体医疗保健质量。此外，他们认为患者有权了解这些信息。然而，另一些人则表示担心，公共报告系统的可靠性可能会受到有害健康影响定义或用于确定有害健康影响的方法和资源方面的体制差异的影响。目前，没有足够的证据表明人力资源状况公共报告系统的优点和局限性。因此，医疗保健感染控制实践咨询委员会（CAPPAC）不建议或反对强制性公开报告HAI率，但是，CAPPAC根据公共卫生和HAI报告系统的既定原则制定了本指南文件。本文件旨在帮助政策制定者、项目规划者、消费者权益组织以及其他负责设计和实施HAI公共报告系统的组织。该文件为立法者提供了一个框架，但没有提供示范立法。联合国艾滋病规划署建议，设计和实施此类系统的人员：1）在设计和实施强制性HAI报告系统时使用既定的公共卫生监测方法; 2）建立多学科咨询小组，包括具有预防和控制HAI专业知识的人员，以监测HAI公共报告系统的规划和监督，3）根据设施类型和逐步实施措施，选择适当的过程和结果措施，以便设施有时间进行调整，并允许对数据有效性进行持续评估;以及4）向医疗保健提供者提供定期和保密的绩效数据反馈。具体而言，CMPAC建议建立HAI公共报告系统的州选择一个或多个适用于其管辖范围内的医院或长期护理机构的以下过程或结果措施：1）中心线插入实践2）外科抗菌预防，3）患者和医护人员中的流感疫苗接种覆盖率; 4）中心线相关血流感染;和5）选定手术后的手术部位感染。随着更多的研究和经验的积累，委员会将更新这些建议。
Since 2002, 4 states have enacted legislation that requires health care organizations to publicly disclose health care-associated infection (HAI) rates. Similar legislative efforts are underway in several Other states. Advocates of mandatory public reporting of HAIs believe that making such information publicly available will enable consumers to make more informed choices about their health care and improve overall health care quality by reducing HAIs. Further, they believe that patients have a right to know this information. However, others have expressed concern that the reliability of public reporting systems may be compromised by institutional variability in the definitions used for HAIs, or in the methods and resources used to identify HAIs. Presently, there is insufficient evidence on the merits and limitations of an HAI public reporting system. Therefore, the Healthcare Infection Control Practices Advisory Committee (HICPAC) has not recommended for or against mandatory public reporting of HAI rates, However, HICPAC has developed this guidance document based on established principles for public health and HAI reporting systems. This document is intended to assist policymakers, program planners, consumer advocacy organizations, and others tasked with designing and implementing public reporting systems for HAIs. The document provides a framework for legislators, but does not provide model legislation. HICPAC recommends that persons who design and implement such systems 1) use established public health surveillance methods when designing and implementing mandatory HAI reporting systems 2) create multidisciplinary advisory panels, including persons with expertise in the prevention and control of HAIs, to monitor the planning and oversight of HAI public reporting systems, 3) choose appropriate process and outcome measures based on facility type and phase in measures to allow time for facilities to adapt and to permit ongoing evaluation of data validity; and 4) provide regular and confidential feedback of performance data to healthcare providers. Specifically, HICPAC recommends that states establishing public reporting systems for HAIs select one or more of the following process or outcome measures as appropriate for hospitals or long-term care facilities in their jurisdictions: 1) central-line insertion practices 2) surgical antimicrobial prophylaxis, 3) influenza vaccination coverage among patients and healthcare personnel; 4) central line-associated bloodstream infections; and 5) surgical site infections following selected operations. HICPAC will update these recommendations as more research and experience become available.