改變換藥流程以降低交互感染之專案

Project to Modifying Dressing Change Procedures in order to Reduce Cross-infection

本專案主要目的是希望藉由改變換藥流程，以降低交互感染率。現況分析發現本單位因PDRAB（Pandrug-resistant Acinetobacter baumannii）的群突發，而使院內感染率高達21.900/00。為尋找原因予詳細觀察各項作業流程，並做環境細菌培養採檢，結果發現兩台換藥車皆呈現A.Baumannii多重抗藥性，且發現工作人員使用換藥車未依標準作業程序，易污染而致交互感染的產生。經由此專案的改善，換藥敷料櫃細菌培養檢測為陰性，感染率也由21.900/00降至16.790/00，同時也讓同仁更加重視感染管控問題，以提供病人更安全的醫療環境。

The aim of this project was to lower the hospital cross-infection rate. This analysis showed that a pan drug-resistant Acinetobacter baumannii (PDRAB) outbreak was resulting in a hospital-acquired infection rate of up to 21.9%. To identify possible reasons for this, we examined the dressing change procedures within the hospital and obtained bacteria cultures from various areas within the hospital environment. We found the presence of positive bacterial cultures on the dressing change carriers that indicated the widespread presence of PDRAB. This was believed to be occurring because staff members were not following standard procedures during dressing change and thoroughly cleaning the working place after each dressing change. After putting this project into practice to modify this behavior, PDRAB was found to be absent from the environment samples and overall cross infection rate was reduced from 21.9% to 16.8%. Furthermore, all staff members now pay more attention to the problem of infection control and are more likely to provide a safer clinical environment for every patient.