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首页> 外文期刊>American Journal of Infection Control >Educational intervention, revised instrument sterilization methods, and comprehensive preoperative skin preparation protocol reduce cesarean section surgical site infections.
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Educational intervention, revised instrument sterilization methods, and comprehensive preoperative skin preparation protocol reduce cesarean section surgical site infections.

机译：教育干预，修订的器械灭菌方法以及全面的术前皮肤准备方案可减少剖宫产手术部位感染。

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BACKGROUND: In 2005, of the approximately 4 million births in the United States, 30% were by cesarean section (C-section) delivery, which translates to roughly over 1 million C-sections in 2005 alone. C-section is associated with higher morbidity than vaginal delivery. Women who undergo C-section are 5 times more likely to develop a postpartum infection after delivery than women who undergo vaginal delivery. OBJECTIVE: Estimates of surgical site infection (SSI) after C-section range from 1.50 to 2.64. A quality improvement initiative was implemented at the University of Minnesota Medical School to reduce rates of SSI using changes based on recommended care initiatives. METHODS: The multidisciplinary team developed a comprehensive staff education and training program, added a preoperative skin preparation protocol using chlorhexidine gluconate (CHG) no-rinse cloths, added CHG with alcohol for interoperative skin preparation, and modified instrument sterilization techniques. RESULTS: Data analysis revealed a statistically significant reduction in the overall SSI rate from 7.5% (33/441) in January-July 2006 to 1.2% (5/436) in January-July 2007 (chi(2) test statistic, 21.2; P < .001; relative reduction of 84%). CONCLUSION: Interventions, including staff education, use of CHG no-rinse cloths for preoperative skin prep, CHG with alcohol for intraoperative skin prep, and appropriate instrument sterilization management led to reductions in SSI rates in patients undergoing C-section at our institution. Rates of endometritis were also noted to be lower after implementation of the interventions.
机译：背景：2005年，在美国约400万例分娩中，有30％是通过剖宫产（剖腹产）分娩的，仅在2005年，剖宫产就超过了100万例。剖腹产的发病率高于阴道分娩。剖腹产的妇女分娩后发生产后感染的可能性是阴道分娩的妇女的5倍。目的：剖腹产后手术部位感染（SSI）的估计范围为1.50至2.64。明尼苏达大学医学院实施了一项质量改进计划，以根据建议的护理计划进行更改以降低SSI发生率。方法：多学科团队制定了一项全面的员工教育和培训计划，增加了术前使用葡萄糖酸洗必泰（CHG）无冲洗布的皮肤准备方案，将CHG与酒精配合使用以进行术中皮肤准备，并改进了器械消毒技术。结果：数据分析显示，总体SSI率从2006年1月-7月的7.5％（33/441）降低到2007年1月-7月的1.2％（5/436），具有统计显着性（chi（2）测试统计量，21.2; P <.001;相对减少84％）。结论：干预措施，包括人员培训，术前使用CHG无冲洗布进行术前准备，术中使用CHG酒精进行术前皮肤准备以及适当的器械消毒管理，均导致本机构剖宫产患者的SSI率降低。实施干预措施后，子宫内膜炎的发生率也较低。

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