Controlul infectiei nosocomialecomponenta majora a sigurantei. pacientului
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1 Controu infectiei nosocomiaecomponenta majora a sigurantei pacientuui Cick to edit Master subtite stye Dr.Roxana Serban, Bucuresti 14 Noiembrie 2013
2 INFECTIA NOSOCOMIALA SI SIGURANTA PACIENTULUI Sursa: Pittet D-The Modern Approach to Infection Contro
3 ISTORIC PRIMA CERINTA INTRUN SPITAL ESTE SA NU FACI RAU BOLNAVILOR Forence Nightingae,
4 ISTORIC Ignaz Phiipp Semmeweis ( ) PIONIER AL PROCEDURILOR de ASEPSIE ( dezinfectia mainii) AUTOR AL UNUI TRATAT DE LIMITARE A INFECTIEI PUERPERALE
5 May 15, Materna Mortaity Ratee mortaitatii materne in cee 2 cinici Obstetrica ae Spitauui Genera din Viena, Semmeweis IP, 1861 First Second
6 Lectiie invatate in controu infectiior si asigurarea caitatii ingrijirior medicae recunoaste expica actioneaza Sursa: Pittet D, Am J Infect Contro 2005, 33:258
7 Abordarea controuui infectiei Sursa: Pittet D, Am J Infect Contro 2005, 33:258
8 Sursa: Pittet D-The Modern Approach to Infection Contro sa controeze infectiie? Poate controu infectiior
9 Abordarea controu infectiei si caitatea ingrijirior medicae in nou mieniu Pittet D, Am J Infect Contro 2005, 33:258
10 WHO WORLD ALLIACE for PATIENT SAFETY Strategia mutimodaa S c h i m b a e d u c a ti M on M ito e riz m C u
11 e Abordarea Nouui Mieniu in controu p i t infectiei si caitatea ingrijirior u m e pi t Abordarea mutidiscipinaran care i i t t recunoaste, spitae u u e c expica si p Ambuatorii i m i t i h a r c actioneaza t azie e i e v n i e e u t Spitae de cronici r t c c r a A e de sevicii Pa dare ipin Sisteme a d r c medicae pentru o o s i acasa Ab tid utim u m m i i g Programme e t a de r St - Sisteme de epidemioo gie Nationae/ Finantat supraveghe ori re Promovarea sigurantei pacientuui
12 WHO 2004 anseaza programu de siguranta a bonavuui Zonee care se intrepatrund si interconditioneaza trebuie sa fie abordate impreuna IN AB rezistent a
13 Infectiie Nosocomiae factoru cheie controu controu infectiei este universa recunoscut ca fiind o baza soida si esentiaa pentru siguranta pacientuui si sprijina reducerea consecinteor infectiior asociate ingrijirior medicae Sursa:Cean Care is Safer Care,WHO, May 2010
14 Sursa ttp:// ).Incidente aproape de 2x mai mari decat in tarie dezvotate vaori intre: %
15 Rezistenta microbiana -factoru cheie consumu de antibiotice paradoxa, presiunea seectiva provine dintr-o combinatie de utiizare excesiva (mute zone ae umii), mai aes pentru infectii minore, abuz datorat ipsei de acces a tratamentu adecvat si consum redus, finaizarea tratamentuui in conditii de resurse financiare precare. Sursa: WHO Goba Strategy for Containmet of Antimicrobia Resistance, _2_EN/en/)
16 EUROPA Prevaenta % (medie 7.1%) pacienti afectati episoade de IN in fiecare an 16 miioane de zie de spitaizare de decese atribuite acestui tip de infectie ( si asociata in ate decese) Impactu econimic - aproximativ 7 miiarde euro (costuri directe) De ex. Marea Britanie in anu 2008 pentru de cazuri IN cu 5000 decese a chetuit un miiard Sursa: ECDC, 2010
17 Directiie de actiune: Supraveghere documentarea probemei Preventia- incetinirea aparitiei IN si AMR Controu - reduce raspandirea Cercetarea dezvotarea de noi metode tehnici
18 DECIZIA europeana Recomandarea Consiiuui European 2009/C151/01 din 9 iunie 2009 si decizia 2119/98/EC privind siguranta pacientior, incusiv prevenirea si combaterea infectiior nosocomiae
19 Modaitati de actiune ae stateor membre A. Nive Nationa/Regiona 1. strategii nationae 1. organism interdepartamenta care să eaboreze si sa supravegheze aceste strategiiși să
20 Modaitati de actiune ae stateor membre - Apicarea strategiei nationae sistem de supraveghere activa a IN (particuarizare pentru fiecare stat membru) - sistem de aerta privind microorganisme cu profi particuar de rezistență a AB si/sau viruentă sporita Raportarea catre ECDC a dateor stabiite
21 Modaitati de actiune ae stateor membre Ate masuri se refera a - definirea si deruarea programeor de pregatire in domeniu controuui infectiior individuaizat pentru: personau dedicat ceeate categorii de persona medica - sprijinirea cercetărior privind epidemioogia IN,
22 Modaitati de actiune ae stateor membre B. La niveu unitatior medicae - Existenta unui program de supraveghere: organizare, proceduri diagnostice si terapeutice pan de supraveghere si contro, dedicat, poitica utiizarii eficente a AB, informarea pacientior - infiintarea unui comitet care să eaboreze si să monitorizeze deruarea acestui program - Existenta de persona suficient si instruit care sa derueze acest program
23 Modaitati de actiune ae stateor membre Actiuni de intreprins a niveu unitatior medicae - formarea continua a personauui dedicat controuui infectiior - activitati de educare medicaa continua privind controu infectiior pentru ate categorii de persona medica si de management din unitatea sanitara
24 Infectia nosocomiaa ROMANIA Supravegherea in Romania ord. 916/2006- rutina programee de sanatate sentinea - PPS SUBRAPORTARE
25 Unde se afa România? Nu avem un organism intersectoria impicat in eaborarea si apicarea strategiior (aaturi de Letonia, Portugaia, Sovenia) NU avem sisteme de supraveghere personaizate a nive nationa (septicemii asociate dispozitiveor, infectii de paga, C difficie, MRSA, EnterobacteracaeNU avem sistem de evauare externa a caitatii testarior de rezistenta microbiana ceea ce impieteaza caitatea si capacitatea de investigare a focareor de infectii nosocomiae
26 Unde se afa România? Nu avem o campanie nationaa privind importanta igienei mainior pentru siguranta pacientuui Nu exista (sub)speciaitate de contro a infectiior si nici programa de pregatire pentru medicii/asistentee ce vor ucra in acest domeniu (16 state au) Nu exista programe de cercetare
27 Unde se afa România? La nive de spita Nu exista resurse financiare specia dedicate acestei probeme ( deconturi CNAS ) Nu exista obigativitatea informarii pacientior privind importanta si eficienta activitatii de supraveghere si contro, in spita (doar 3 state au asemenea regementări) Nu exista mecanisme de stimuare a informarii pacientior privind riscu IN (10 state au asemenea mecanisme)
28
29 Unde se afa România? DAR Abordarea probemei se face prin intermediu programeor de sanatate si egisatie dedicata Avem notificarea statistica nationaa a infectiior nosocomiae pe cauze si pe sectii Avem supraveghere de tip sentinea Avem sistem de aertare pentru focare de IN Avem institutii care reactioneaza a aceste aerte Avem aboratoare de referinta
30 SUCCESUL? MESAJ pentru TOTI ACTORII impicati Impicarea si coaborarea TREBUIE vazute cu ati ochi
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