改善中心靜脈導管相關血流感染率專案

Project to Reduce the Central Venous Catheter-Related Bloodstream Infection Rate

背景：中心靜脈導管相關血流感染是醫療照護品質重要指標之一，本加護單位2009年1月至12月平均中心靜脈導管相關血流感染率為10.27‰，引發專案小組改善動機。調查發現問題主要為醫護人員在預防血流感染執行正確率低與未更新照護標準流程所致。目的：本專案旨在降低內科加護病房中心靜脈導管相關血流感染率至5.0‰以下。解決方案：經文獻查證及團隊討論後，設立改善策略，包括(1)辦理在職教育以提升醫療人員照護正確率；(2)制定中心靜脈導管置入、照護及監測查檢表，定期稽核執行正確性；(3)更新置入及照護標準流程，使同仁可依循作業。結果：中心靜脈導管相關血流感染率由10.27‰降至1.43‰。結論：期望藉此專案分享團隊合作降低加護單位血流感染率，提升重症照護品質的經驗，進而降低醫療成本。

Background: Central venous catheter-related bloodstream infection (CRBSI) is an important indicator of care quality. The average CRBSI rate in our unit was 10.27‰ in 2009. Causes of infection included inadequate CRBSI prevention practices and outdated standard procedures.Purpose: We designed a project to reduce the CRBSI rate below 5.0‰ in our intensive care unit.Resolution: Improvement plans included providing in-service education, establishing a central venous catheter (CVC) care checklist, and updating CRBSI clinical management standards.Results: The CRBSI rate fell to 1.43‰ after implementation. This was significantly below the reduction target of 5.0‰.Conclusions: This project effectively reduced CRBSI. We want to share this experience to help other hospitals and units improve critical care quality and reduce healthcare costs.