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首页> 外文期刊>Trials >The effect of implementing an aseptic practice bundle for anaesthetists to reduce postoperative infections, the Anaesthetists Be Cleaner (ABC) study: protocol for a stepped wedge, cluster randomised, multi-site trial
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The effect of implementing an aseptic practice bundle for anaesthetists to reduce postoperative infections, the Anaesthetists Be Cleaner (ABC) study: protocol for a stepped wedge, cluster randomised, multi-site trial

机译：实施麻醉师术后感染的无菌实践捆绑的效果，麻醉师是清洁的（ABC）研究：阶梯楔形的协议，群集随机，多场试验

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Postoperative infection is a serious problem in New Zealand and internationally with considerable human and financial costs. Also, in New Zealand, certain factors that contribute to postoperative infection are more common in Māori and Pacific populations. To date, most efforts to reduce postoperative infection have focussed on surgical aspects of care and on antibiotic prophylaxis, but recent research shows that anaesthesia providers may also have an impact on infection transmission. These providers sometimes exhibit imperfect hand hygiene and frequently transfer the blood or saliva of their patients to their work environment. In addition, intravenous medications may become contaminated whilst being drawn up and administered to patients. Working with relevant practitioners and other experts, we have developed an evidence-informed bundle to improve key aseptic practices by anaesthetists with the aim of reducing postoperative infection. The key elements of the bundle are the filtering of compatible drugs, context-relevant hand hygiene practices and enhanced maintenance of clean work surfaces. We will seek support for implementation of the bundle from senior anaesthesia and hospital leadership and departmental "champions". Anaesthetic teams and recovery room staff will be educated about the bundle and its potential benefits through presentations, written material and illustrative videos. We will implement the bundle in operating rooms where hip or knee arthroplasty or cardiac surgery procedures are undertaken in a five-site, stepped wedge, cluster randomised, quality improvement design. We will compare outcomes between approximately 5000 cases before and 5000 cases after implementation of our bundle. Outcome data will be collected from existing national and hospital databases. Our primary outcome will be days alive and out of hospital to 90?days, which is expected to reflect all serious postoperative infections. Our secondary outcome will be the rate of surgical site infection. Aseptic practice will be observed in sampled cases in each cluster before and after implementation of the bundle. If effective, our bundle may offer a practical clinical intervention to reduce postoperative infection and its associated substantial human and financial costs. Australian New Zealand Clinical Trials Registry, ACTRN12618000407291 . Registered on 21 March 2018.
机译：术后感染是新西兰的严重问题，并具有相当多的人力和财务成本。此外，在新西兰，在毛利和太平洋人口中有助于术后感染的某些因素。迄今为止，大多数减少术后感染的努力都集中在护理和抗生素预防的手术方面，但最近的研究表明麻醉提供者也可能对感染传播产生影响。这些提供商有时展示不完美的手卫生，并且经常将患者的血液或唾液转移到其工作环境中。此外，静脉内药物可能会被污染，同时制定并给予患者。与相关的从业者和其他专家合作，我们制定了一份证据通知的捆绑，以改善麻醉师的关键无菌实践，目的是降低术后感染。捆绑的关键要素是兼容药物的过滤，上下文相关的手卫生习惯和加强清洁工作表面的维护。我们将寻求支持从高级麻醉和医院领导和部门“冠军”的捆绑。麻醉团队和恢复室工作人员将通过演示，书面材料和说明视频教育捆绑和其潜在利益。我们将在五个地点，阶梯式楔形，集群随机化，质量改进设计中实施髋关节或膝关节形成术或心脏手术程序的手术室中的捆绑。我们将在实施我们捆绑后的大约5000例之前的案件之间进行比较。结果数据将从现有的国家和医院数据库中收集。我们的主要结果将是活跃的日子和医院到90？天，预计将反映所有严重的术后感染。我们的次要结果将是手术部位感染的速率。在捆绑的实施之前和之后的每个群集中的采样案例中将观察到无菌案例。如果有效，我们的捆绑可以提供实际的临床干预，以减少术后感染及其相关的大量人体和财务费用。澳大利亚新西兰临床试验登记处，ACTRN12618000407291 2018年3月21日注册。

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