應用手術部位感染組合照護模式降低大腸直腸手術發生術後手術部位感染

Implemention of Surgical Care Bundle to Reduce Surgical Site Infection Risk in Colorectal Surgery

目的：本研究探討大腸直腸手術在降低手術部位感染組合式照護模式(SSI Bundle)導入後，SSI Bundle各執行項目遵循率（如：血糖控制、皮膚準備及沐浴等）及術後手術部位感染率改善成效。

材料（或研究對象）與方法：本研究以臺北市某醫學中心接受大腸直腸手術病人為研究對象，醫院於2016年6月組成跨團隊小組，執行SSI Bundle計畫。研究資料收集區間由2016年1月至2018年12月資料，分為介入前(107人)及介入後(247人)。

結果：手術部位感染率由SSI Bundle介入前13.7%降低到介入後6.7%，各項SSI Bundle遵循項目也有顯著提昇（術前檢測血糖、術前沐浴等項目），並證實有吸菸習慣及接受緊急手術病人為術後手術部位感染重要風險因子。

結論：本研究證實醫院整合跨團隊資源進行SSI Bundle計畫導入，可有效提昇Care Bundle項目執行遵循率，並降低術後手術部位感染風險。

 

Objective: This study explored the effectiveness of SSI bundle indicators in the implementation of SSI bundle after the introduction of SSI bundle (such as blood glucose control, and skin cleansing and bathing) and the postoperative surgical site infection rate.

Methods: This study was conducted in a medical center in Taipei, Taiwan, with patients undergoing colorectal surgery. The hospital established a cross-disciplinary team in June 2016 to implement the SSI bundle program. Data were collected from January 2016 to December 2018, and participants were divided into control (107 people) and intervention (247 people) groups.

Results: The surgical site infection rate after SSI bundle intervention decreased from 13.7% to 6.7%. preoperative skin cleansing) improved significantly, confirming that smoking habits and emergency surgery are essential risk factors for postoperative surgical site infection.

Conclusions: The study results suggest that hospitals must integrate cross-disciplinary resources to introduce the SSI bundle program. This strategy can effectively improve the implementation compliance rate of the Care Bundle project and reduce the risk of postoperative surgical site infection.