Cited 0 times in

39 7

일개 대학병원 신경외과중환자실에서 Clostridium difficile 관련 설사 감소를 위한 CQI활동

Other Titles
 CQI activities for the reduction of Clostridium difficile associated diarrhea in NCU of a University Hospital. 
Authors
 박은숙 ; 장경희 ; 김준명 ; 이경원 ; 신정원 ; 김선호 ; 여한승 ; 김태곤 ; 이정신 ; 윤영옥 
Citation
 Quality Improvement in Health Care (한국의료QA학회지), Vol.8(1) : 10~21, 2001 
Journal Title
 Quality Improvement in Health Care (한국의료QA학회지) 
ISSN
 1225-7613 
Issue Date
2001
Abstract
Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.
URI
http://ir.ymlib.yonsei.ac.kr/handle/22282913/142793
Appears in Collections:
1. 연구논문 > 1. College of Medicine > Dept. of Laboratory Medicine
1. 연구논문 > 1. College of Medicine > Dept. of Internal Medicine
Yonsei Authors
사서에게 알리기
  feedback
Files in This Item:
T200103032.pdfDownload
Export
RIS (EndNote)
XLS (Excel)
XML

qrcode

Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.

Browse