Öz
Hastane kaynaklı enfeksiyonların insidansı, invaziv girişimlerin artması ve gelişen teknoloji ile hastanede yatış sürelerinin uzaması gibi nedenlerle artmaktadır. Kullanılan geniş spektrumlu antibiyotikler, çok ilaca dirençli mikroorganizmalarla kolonizasyon ve enfeksiyonların sıklığının artmasına neden olmaktadır. Tedavide kullanılacak antibiyotik seçeneklerinin de kısıtlı olması nedeniyle enfeksiyon kontrol önlemlerinin önemi artmıştır. Enfeksiyon kontrol önlemlerinin tek tek uygulanması yerine birimlerin özelliklerine göre üç veya beş önlemin birlikte demet halinde uygulanması daha etkili bulunmuştur. Enfeksiyon kontrol demetleri sıklıkla, ventilatör ilişkili pnömoni, santral kateter ilişkili kan dolaşımı enfeksiyonu, kateter ilişkili üriner sistem enfeksiyonu, cerrahi alan enfeksiyonu ve dirençli Gram-olumsuz mikroorganizmaların yayılımının önlenmesine yönelik olarak uygulanmaktadır. Uygulanan demet parametrelerinin yedi gün 24 saat uygulanabilir ve denetlenebilir olması önemlidir. Bütün demet uygulamalarında temel prensipler; invaziv aletlerin gereksiz uygulanmaması, günlük tıbbi uygulamalar sırasında asepsi ve antisepsi kurallarına uyum, invaziv alet kullanımının en kısa sürede sonlandırılması ve el hijyenine uyum olarak görülmektedir. Enfeksiyon kontrol demetlerinin uygulanması sonrasında hastalara kanıta dayalı, güvenli sağlık hizmetinin düzenli bir yaklaşımla sunulması için önemli bir fırsat yaratılmaktadır. Demet uygulamaları sonrası enfeksiyon kontrol komitelerine düşen görev ise, sürveyans uygulamaları ile demet parametrelerine uyum ve enfeksiyon oranlarını takip edip geri bildirimini yapmaktır. Yapılan geri bildirimler sayesinde enfeksiyon kontrol demetlerine uyum hızlarında artış ve buna bağlı enfeksiyon oranlarında gerileme görülmektedir. Bu çalışmada literatürde bildirilen ve birimlerde uygulanan demet parametreleri belirtilmiş ve bu parametrelere uyum sayesinde hastane enfeksiyonlarında gözlenen değişiklikler derlenmiştir.
Anahtar Kelimeler: Hastane enfeksiyonları, enfeksiyon kontrolü, enfeksiyon kontrol demeti, ventilatör ilişkili pnömoni, kateter ilişkili kan dolaşımı enfeksiyonu
Kaynakça
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