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Ressourcenschonung aus Sicht der Hygiene

Resource conservation from the perspective of infection prevention

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Zusammenfassung

Hintergrund

Maßnahmen zur Prävention postoperativer Wundinfektionen benötigen einen hohen Einsatz personeller, technischer und natürlicher Ressourcen. In diesem Beitrag werden Möglichkeiten zur optimalen Ressourcennutzung bei der Versorgung chirurgischer Patient:innen ohne Verschlechterung von deren Sicherheit untersucht.

Methoden

Bewertung des Evidenz- und Empfehlungsgrads von Maßnahmen zur Infektionsprävention bei chirurgischen Patient:innen anhand gültiger Leitlinien im Vergleich mit Ergebnissen aktueller klinischer Studien; Analyse von Interventionen zur Implementierung von Maßnahmen und Steigerung der Compliance.

Ergebnisse

Die Kenntnis aktueller evidenzbasierter Empfehlungen ermöglicht nicht nur die Identifizierung infektionspräventiv wirksamer, sondern auch wirkungsloser und damit verzichtbarer Prozeduren. Es besteht weiterhin Bedarf an kontrollierten Studien, z. B. zum Einsatz von Antiseptika, die den Evidenzgrad von Präventionsmaßnahmen belegen können. Infektions-Surveillance in Kombination mit Prozess- und Compliancebeobachtungen durch Hygienefachpersonal mit einem Feedbacksystem an das klinisch tätige Personal sind geeignete Steuerungsinstrumente für krankenhaushygienische Maßnahmen. Bei erhöhten Infektionsraten ist die Implementierung mit Evidenz belegter empfohlener Maßnahmen durch maßgeschneiderte Bündelintervention erfolgreich. Technische Maßnahmen zur Aufrechterhaltung von Umgebungsbedingungen müssen in den Steuerungsprozess eingeschlossen werden.

Schlussfolgerung

Die Reduktion nosokomialer Infektionen durch maßgeschneiderte Implementierung infektionspräventiver Maßnahmen sowie der Verzicht auf wirkungslose Maßnahmen schonen Ressourcen und verbessern die Patientensicherheit.

Abstract

Background

Procedures to prevent surgical site infections require a high input of human, technical and natural resources. This paper explores ways to optimize the use of resources in caring for patients who undergo a surgical procedure without compromising patient safety.

Methods

Review of the contribution of selected procedures for infection prevention in surgical patients considering current evidence and recommendations by comparing current guidelines and results of clinical trials. Analysis of interventions to implement and increase compliance.

Results

Knowledge of current evidence-based recommendations enables not only the identification of procedures with proven effect on infection prevention but also those that are ineffective and thus dispensable. There is still need for further controlled studies, e.g. on the use of antiseptics, that can confirm the evidence level of preventive procedures. Infection surveillance in combination with process and compliance monitoring by infection prevention specialists with a feedback system to healthcare workers are suitable control instruments for infection control management. In the case of increased infection rates, the implementation of evidence-based recommended measures through tailored bundle interventions is successful. Technical measures to maintain environmental conditions must be included in the control process.

Conclusion

The reduction of healthcare-associated infections by implementing tailored interventions of infection prevention measures and elimination of ineffective procedures conserves resources and promotes patient safety.

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Authors and Affiliations

  1. Institut für Hygiene, Krankenhaushygiene und Umweltmedizin, Zentrum für Infektionsmedizin, Universitätsklinikum Leipzig, Liebigstr. 22, 04103, Leipzig, Deutschland

    Susanne Kolbe-Busch & Iris F. Chaberny

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  1. Susanne Kolbe-Busch
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  2. Iris F. Chaberny
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Correspondence to Susanne Kolbe-Busch.

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Interessenkonflikt

S. Kolbe-Busch und I.F. Chaberny geben an, dass kein Interessenkonflikt besteht.

Für diesen Beitrag wurden von den Autor/-innen keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

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I. Gockel, Leipzig

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Kolbe-Busch, S., Chaberny, I.F. Ressourcenschonung aus Sicht der Hygiene. Chirurgie 94, 220–229 (2023). https://doi.org/10.1007/s00104-022-01784-8

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