Korean Journal of Clinical Laboratory Science (대한임상검사과학회지)

Korean Society for Clinical Laboratory Science (대한임상검사과학회)
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Evaluation of the Effectiveness of Surveillance on Improving the Detection of Healthcare Associated Infections

의료관련감염에서 감시 개선을 위한 평가

  • Park, Chang-Eun (Department of Biomedical Laboratory Science, Molecular Diagnostics Research Institute, Namseoul University)
  • 박창은 (남서울대학교 임상병리학과.분자진단연구소)
  • Received : 2019.01.12
  • Accepted : 2019.01.29
  • Published : 2019.03.31
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Abstract

The development of reliable and objective definitions as well as automated processes for the detection of health care-associated infections (HAIs) is crucial; however, transformation to an automated surveillance system remains a challenge. Early outbreak identification usually requires clinicians who can recognize abnormal events as well as ongoing disease surveillance to determine the baseline rate of cases. The system screens the laboratory information system (LIS) data daily to detect candidates for health care-associated bloodstream infection (HABSI) according to well-defined detection rules. The system detects and reserves professional autonomy by requiring further confirmation. In addition, web-based HABSI surveillance and classification systems use discrete data elements obtained from the LIS, and the LIS-provided data correlates strongly with the conventional infection-control personnel surveillance system. The system was timely, acceptable, useful, and sensitive according to the prevention guidelines. The surveillance system is useful because it can help health care professionals better understand when and where the transmission of a wide range of potential pathogens may be occurring in a hospital. A national plan is needed to strengthen the main structures in HAI prevention, Healthcare Associated Prevention and Control Committee (HAIPCC), sterilization service (SS), microbiology laboratories, and hand hygiene resources, considering their impact on HAI prevention.

감염감시를 위한 신뢰성 있고 객관적인 의료관련 감염의 정의 및 자동화 된 프로세스를 개발하는 것이 중요하다. 그러나 자동화 된 감시 시스템으로의 전환은 여전히 어려운 과제이다. 초기의 발생 확인은 대개 비정상적인 사건과 진행중인 질병 감시를 인식하는 임상 검사자들이 기준선 비율을 결정하도록 요구한다. 이 시스템은 잘 정의 된 감시 규칙에 따라 의료 관련 혈류 감염의 후보를 감시하기 위해 매일 검사정보 시스템 데이터를 검사한다. 시스템은 추가 확인을 요구함으로써 전문적인 자율성을 탐지하고 예약한다. 또한 웹 기반 혈류감염 감시 및 분류 시스템은 검사실 정보 시스템에서 얻은 개별 데이터 요소를 사용할 수 있고 검사정보 시스템은 기존의 감염 제어 인력 감시 시스템과 높은 상관관계가 있는 데이터를 제공한다. 이런 시스템은 예방 지침에 따를 경우 적절하고, 수용 가능하며, 유용하고 민감하다. 감시 시스템은 병원에서 광범위한 병원균의 전파가 언제 어디서 발생하는지에 대한 이해를 획기적으로 향상시키기 때문에 유용하다. 국가적 차원의 계획은 의료관련감염 예방, 보건 관련 예방 통제위원회(HAIPCC), 살균 서비스(SS), 미생물학 실험실, 손 위생 차원의 주요 구조를 강화하기 위해 추진되어야하며 해당 지역은 의료관련 감염 예방에 미치는 영향을 고려하여 선정해야 한다.

Keywords

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