Bündel zur Prävention nosokomialer Infektionen

Kernaussagen

• Mit „Bündeln” gelingt es, die Qualität der Patientenversorgung messbar zu verbessern.

• Als „Bündel” wird eine Gruppe von (meist 3 – 6) evidenzbasierten Interventionsmaßnahmen bezeichnet, die gemeinsam implementiert werden.

• Eine größere Zahl von Studien konnte zeigen, dass sich die Häufigkeit bestimmter nosokomialer Infektionen drastisch verringern lässt, wenn als Bündelkomponenten solche Maßnahmen gewählt werden, deren infektionspräventive Wirksamkeit möglichst gut belegt ist und wenn diese Maßnahmen mit hoher Compliance (möglichst > 95 %) umgesetzt werden.

• Essenziell für die Implementierung eines Bündels ist die Information und Fortbildung des medizinischen Personals, eine klare Regelung der Zuständigkeiten, gute Teamarbeit, die kontinuierliche Messung der Compliance und die Surveillance des zu beeinflussenden klinischen Outcomes (z. B. Infektionsfälle) sowie das Feedback der gemessenen Compliance– und Infektionsdaten an das zuständige Personal.

• Einige schwere nosokomiale Infektionen, insbes. Beatmungspneumonien und gefäßkatheterassoziierte Blutstrominfektionen, wurden mit Bündeln so erfolgreich bekämpft, dass seit Kurzem erstmals ernsthaft über die Möglichkeit der Elimination nosokomialer Infektionen nachgedacht wird.

• Innerhalb einer Gesamtstrategie zur Verbesserung der Patientenversorgung sind Bündel ein wichtiges Instrument zur Verbesserung der Patientensicherheit.

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