ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120788.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120789.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120790.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120791.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120792.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120793.x

出版商:Wiley    

年代:1988

数据来源: WILEY

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120794.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

The first national survey of the prevalence of nosocomial and community‐acquired infections in Australian hospitals was carried out during July 1984. Data were collected on 28 643 patients in rural and metropolitan, public and private acute‐care hospitals. The over‐all adjusted prevalence of nosocomial infections was 6.3%; the prevalence of community‐acquired infection was 9.7%. A total of 5940 infections occurred; 39% were hospital‐ acquired infections and 61% were community‐acquired infections. These occurred at the following sites: the respiratory tract, 35.4% (2100 infections; contributing 19% of hospital‐acquired infections and 46% of community‐acquired infections); the urinary tract, 15.1% (896 infections; contributing 22% of hospital‐acquired infections and 11% of community‐ acquired infections); surgical wounds, 13.4% (797 infections; contributing 34% of hospital‐acquired infections); the gastrointestinal tract, 7.8% (466 infections; contributing 3.4% of hospital‐acquired infections and 11 % of community‐acquired infections); skin, 6.3% (376 infections; contributing 4.4% of hospital‐acquired infections and 8% of community‐acquired infections); abscesses, 1.9% (113 infections; contributing 0.9% of hospital‐acquired infections and 2% of community‐acquired infections); traumatic wounds, 1.5% (90 infections; contributing 0.9% of hospital‐acquired infections and 2% of community‐acquired infections); bacteraemia, 1.5% (89 infections; contributing 1.6% of hospital‐acquired infections and 1% of community‐ acquired infections); burns, 0.2% (14 infections; contributing 0.3% of hospital‐acquired infections and 0.2% of community‐acquired infections); and others, 16.8% (999 infections; contributing 13.4% of hospital‐acquired infections and 19% of community‐acquired infections). There was a significant association between hospital size and infection rates. The nosocomial infection prevalence rate increased from 4.2% in hospitals with 50‐99 beds to 7.6% in hospitals with 500 or more beds. The prevalence of community‐ acquired infections was higher in rural (11.5%) than in metropolitan (8.7%) hospitals. After adjusting for hospital size, public hospitals had significantly‐ higher prevalences of nosocomial (6.7%) and community‐acquired (10.6%) infection than did private hospitals (nosocomial infection, 4.8%; community‐ acquired infection, 6.3%).

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120795.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

In July 1984, the first national Australian Nosocomial Prevalence Survey collected data on 12 742 surgical patients from 265 hospitals. This sample represented 59% of public and private hospitals with 50 or more acute‐care beds in Australia. The infection control officers at each hospital provided data on patients in a random sample of beds. The over‐all surgical wound infection rate was 4.6%. The surgical wound infection rate was twice (5.4%) as high in public than in private (2.8%) hospitals. The infection rates were greater in larger hospitals in both the public and private sector. However, after adjusting for the other predictor factors that are noted below the infection rate did not show any particular pattern for the size of hospital. Clean surgery had a higher (4.8%) infection rate than did clean‐contaminated surgery (2.9%). The infection rate for contaminated surgery was 15.0%. Men were found to have nearly twice (6.5%) the infection rate of women (3.4%). Infection rates were lowest in the 15‐to‐34 years' age‐group and highest in those of over 55 years of age. These trends remained even after adjusting for the other risk factors for infection. The cost of surgical wound infections for all hospitals during the year of 1984 was estimated at approximately $60 million. We suggest that a concerted effort should be made to attempt to reduce the infection rate for clean surgery to 1% or less.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120796.x

出版商:Wiley    

年代:1988

数据来源: WILEY

摘要:

A controlled cross‐over study in 12 Victorian public hospitals was performed to examine the power of marketing techniques in influencing prescribing. The targeted prescribing behaviour was the use of antibiotic prophylaxis in surgery, and the criteria for judging the appropriateness of therapy were its duration and timing, as are detailed in the fourth edition of the bookletAntibiotic guidelines.The first intervention was mounted in 1985 in six hospitals (two metropolitan teaching hospitals, one suburban general hospital and three rural hospitals), and six matched hospitals acted as control hospitals. One year later, the intervention was mounted in the six hospitals that previousiy had been the control hospitals. The interventional campaign consisted of material that was similar to that which is used by the pharmaceutical industry, including an “academic” representative. Its effect was assessed by audits that were performed before and after the first interventional campaign and again, one year later, after the second interventional campaign. The proportion of antibiotic courses that were assessed as satisfactory in terms of duration increased significantly after the first campaign in the hospitals where the intervention was mounted. No significant changes in prescribing occurred in the control hospitals. In the hospitals which were control hospitals in 1985, and in which the intervention occurred in 1986, the proportion of antibiotic courses that were assessed as satisfactory also increased significantly after the interventional campaign. A fall‐off in performance occurred during the 12 months after the campaign in the 1985‐interventional hospitals. Calculated cost savings more than outweighed the costs of the campaign. We conclude that inappropriate prescribing behaviour in hospitals can be modified successfully by educational marketing techniques.

ISSN:0025-729X    

DOI:10.5694/j.1326-5377.1988.tb120797.x

出版商:Wiley    

年代:1988

数据来源: WILEY