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Prävention nosokomialer Infektionen durch Bündel

Evidenz und praktische Umsetzung

Prevention of nosocomial infections by bundles

Evidence and practical implementation

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Zusammenfassung

Zur Prävention häufiger nosokomialer Infektionen wurde bereits eine Vielzahl von Leitlinien erstellt. Die mangelnde Umsetzung in die Praxis ist jedoch ein häufiges Problem, deren Hintergründe vielfältig sind. Um über eine Priorisierung von Maßnahmen die Implementierung zu vereinfachen, wurde das Bündelkonzept entwickelt. Ein Bündel besteht nur aus drei bis fünf praktischen Maßnahmen, deren Relevanz evidenzbasiert ist. Sehr erfolgreich wurde das Konzept zur Vermeidung von katheterassoziierten Blutstrominfektionen und beatmungsassoziierten Pneumonien angewendet. Nur die vollständige Erfüllung aller Komponenten bedeutet eine erfolgreiche Umsetzung, und nur eine hohe Compliance bei der Umsetzung verbessert die Infektionsrate signifikant. Von entscheidender Bedeutung ist somit die richtige Implementierung. Diese beinhaltet eine gute Planung mit Festlegung der Verantwortlichkeiten, Schulungen der einzelnen Maßnahmen, Überwachung der Compliance sowie Surveillance der Infektionsraten.

Abstract

There are numerous guidelines for the prevention of hospital-acquired infections; however, adherence to these guidelines is only limited. The bundle concept was developed to facilitate the implementation by prioritizing certain measures. A bundle contains 3–5 evidence-based key interventions. The bundle concept has been successfully applied to reduce central catheter-related bloodstream infections and ventilation-associated pneumonia whereby only strict compliance can help to reduce infections; therefore, the right implementation strategy is essential. This means accurate planning, delegation of responsibilities, education, control of compliance and infection surveillance.

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  1. Institut für Medizinische Mikrobiologie, Immunologie und Hygiene, Trogerstr. 30, 81675, München, Deutschland

    F.E. Gebhardt &  N. Wantia

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  1. F.E. Gebhardt
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  2. N. Wantia
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Correspondence to F.E. Gebhardt or N. Wantia.

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Gebhardt, F., Wantia, N. Prävention nosokomialer Infektionen durch Bündel. Med Klin Intensivmed Notfmed 108, 119–124 (2013). https://doi.org/10.1007/s00063-012-0157-3

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  • DOI: https://doi.org/10.1007/s00063-012-0157-3

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