抗生素PPT课件（英文精品） Surgical Infection Prevention In Washington State(50p)PPT.ppt

Surgical Infection PreventionIn Washington StateWhere we started and where we’re going…;Why focus on surgical quality?;Consequences of Surgical Complications;Who Pays for Surgical Complications?;CMS;Selected Surgical Procedures;Antibiotic Timing Related to Incision Where we started in 2001;Classen. NEJM. 1992;328:281.;Infection antibiotic IndicatorsNational Surgical Care Improvement Project;Surgical Care Improvement ProjectPerformance measures - Process;INF – 1: the questions;INF-1: What works! ;SCIP INF – 2: SelectionAntibiotic Recommendation Sources;#1 – Currently published guidelines…;#2 – Be cautious about wanting to use vancomycin for prophylaxis;INF - 2: Selection: the questions;INF – 2: What works!;SCIP INF – 3: Discontinuation of Prophylaxis;SCIP #3: Discontinuation of Antibiotics;Duration of Antibiotic Prophylaxis:What is Best for Our Patients?;Antibiotic ProphylaxisDuration; Duration of prophylactic antibiotic administration should not exceed the 24-hour post-operative period. Prophylactic antibiotics should be discontinued within 24 hours of the end of surgery. Medical literature does not support the continuation of antibiotics until all drains or catheters are removed and provides no evidence of benefit when they are continued past 24 hours.;INF – 3: What works!;INF – 3: What works!;Protocols, protocols, protocols;Surgical Care Improvement ProjectPerformance measures - Process;Glucose Control Lowers the Risk of Wound Infection in Diabetics After Open Heart OperationsZerr et al Portland, OR 1997   ;INF – 4: Glucose Control: the questions;INF – 4: What works!;INF – 6: Hair removal;Influence of Shaving on SSI;INF – 6: the questions;INF – 6: What works! ;SCIP INF – 7: Temperature Control;INF – 7: Temp control: the questions;INF – 7: What works!;38;Surgical Care Improvement Project (SCIP);Prevention of Cardiac EventsIntroduction;Surgical Care Improvement ProjectPerforman