運用Power BI進行中心靜脈導管相關血流感染監測

Monitor Central Line-Associated Bloodstream Infection by Using Power BI

中部某醫學中心每年依風險評估訂定年度感染管制計畫，依據2021年風險評估結果中心靜脈血流感染為前三名應優先處理之項目。透過文獻可知血流感染，依據文獻證實每發生一件血流感染除了增加住院天數、費用支出外，另外也提高了死亡風險，是病人照護及安全的一項重要指標。故本院嘗試導入商業智能大數據處理工具Power BI，先由篩檢發燒病人出發，確認發燒病人是否有置入中心靜脈導管，橫向關聯不同來源資料庫，蒐集並分析中心靜脈導管組合式照護每日照護執行情形，並即時給予監測趨勢圖，利於臨床評估及監測中心靜脈導管相關血流感染。將商業智能Power BI儀表板設置於護理站之電子白板，可藉由簡單易懂的視覺化互動查詢介面，利用直覺式操作、即時互動等功能，快速整合臨床照護資訊於同一平台，可讓臨床使用者快速直觀掌握病房動態並即時啟動評估與介入措施。導入Power BI後，急性加護病房中心靜脈導管相關血流感染密度，由導入前2021年第一季（千分之5.10）降至第四季（千分之4.38）、呼吸加護病房由導入前2021年第一季（千分之4.28）降至第四季（千分之2.44），以此初步結果來看，導入商業智能Power BI，或許可以藉由視覺化提醒，來改善住院病患中心靜脈導管相關血流感染的比率，但仍須長時間、多單位及多中心的實際運用資料來進一步分析商業智能Power BI於醫療照護相關感染管制的成效。

Central line-associated bloodstream infection (CLABSI) is the most common cause of healthcare-associated infection. The consequences of CLABSI can be serious and result in sepsis, a life-threatening condition. CLABSI can also prolong hospital stays, increase mortality risk, and increase healthcare costs. It has been identified as one of the annual patient safety goals over the past several years. In 2021, according to the results of the annual risk assessment at our hospital, CLABSI was one of the three most important projects that should be prioritized for management. Power BI is a powerful business intelligence tool that allows users to connect to a variety of data sources, perform data analysis, and create visually appealing and interactive reports and dashboards. By introducing Power BI to monitor CLABSI, healthcare facilities can gain valuable insights into the CLABSI rates and other relevant metrics, which can help healthcare providers identify problem areas and take action. It can easily share data and results with others within the facility and improve transparency and engagement. After introducing Power BI, the average infection density of CLABSI in intensive care units decreased from (5.10 per mille) in the first quarter of 2021 to (4.38 per mille) in the fourth quarter, and in respiratory care centers decreased from (4.28 per mille) in the first quarter of 2021 to (2.44 per mille) in the fourth quarter. Based on these preliminary findings, the introduction of Power BI to monitor CLABSI to remind healthcare providers could affect the impact of CLABSI. Further large-scale studies are required to assess the long-term effect of Power BI on the control of healthcare-related infections.