流行病学在护理的应用与文献查证

流行病学在护理的应用与文献查证流行病学在护理的应用与文献查证第1页序言流行病學是“方法學”也是“一門學問”流行病學是公共衛生基礎與護理關連不一样護理專科實務與研究流行病学在护理的应用与文献查证第2页流行病學在護理上應用Communityhealthnursing(社區衛生護理)Infectioncontrolpractice(感染控制)Occupationalandenvironmentalhealth(職業與環境衛生)研究流行病学在护理的应用与文献查证第3页社區衛生護理社區衛生護理公共衛生護理專業初段、次段、與末段預防居家照護學校衛生護理工作場所流行病学在护理的应用与文献查证第4页感染控制院內感染(Nosocomialinfection)“Infectionsappearinginhospitalizedpatientsthatwerenotpresentorincubatingatthetimeofadmission”(Blake,1995,p.214)普通管染管控可分為“Surveillanceandreporting”“Controlandprevention”流行病学在护理的应用与文献查证第5页TypesofSurveillanceTotalhousesurveillanceOthersPriority-directed/targetedsurveillanceProblem-oriented/outbreakresponsesurveillancePrevalencesurvey/riskfactors流行病学在护理的应用与文献查证第6页醫院內流行病學應用院內醫護人員或病人針扎背痛跌倒其它Medicalerrors術後合併症病人滿意度流行病学在护理的应用与文献查证第7页InterdisciplinaryModelforOccupationalHealthHealthPromotionHealthprotectionHealthscreeningHealtheducationHealthSurveillanceEnvironmentalmonitoringDatacollectionSafetyErgonomicsOccupationalHealthNurseOccupationalHealthPhysicianLifeStyleProgramsIndustrialHygieneEpidemiologyIndustrialSafetyManagement流行病学在护理的应用与文献查证第8页RiskAssessmentProcessFocusoftheriskassessmentWhatisthepurpose?IdentificationofneedsClarificationofproblemAnalysisofdesire(desireforanexerciseprogram)IdentificationofresourceUseofresourceWhatisthescopeoftheprogram?Whatdoyouintendtoaccomplish?Howlargeistheemployeepopulation?Doyouhavetheneededexpertise?Isthetimeavailable?Whatisthecost/benefitratio?AreasofassessmentEmployeesWorkenvironmentOrganizationalresourcesHealtheffectsEconomicimpact流行病学在护理的应用与文献查证第9页研究Toidentifyriskfactorforinfectioncontrolpractice(ICP)範例:RiskfactorsfornosocomialbloodstreaminfectionsAretrospectivestudyof205patientswasperformedtoidentifytheriskfactorsassociatedwithnosocomialbloodstreaminfection(BSI)Thestudyoccurredduringa5-monthperiodinfourmedical–surgicalintensivecareunits(ICUs)inAthens,GreeceRiskfactorsweredeterminedusingsingleandmultivariateanalysesThirty-fivepatientsdevelopednosocomialBSI(17.1%)Theincidencedensity(definedasthenumberofnewcasesofBSIdividedbythetotalofpatient-daysinthepopulationstudiedofBSIwas14.3per1000patient-days(totalnumberofdaysthatpatientsareintheICUduringtheselectedtimeperiod)Threeriskfactorswereidentified:ThelengthofICUstay(adjustedoddsratios(AOR)1.052,95%confidenceinterval(CI)1.018–1.087,P=0.002)Thepresenceoftraumaatadmission(AOR2.622,95%CI1.074–6.404,P=0.034)Nosocomialventilator-associatedpneumonia(AOR6.153,95%CI2.305–16.422,P=0.000)流行病学在护理的应用与文献查证第10页ReferencesHarkness,G.(1995).Epidemiologyinnursingpractice.Mosby:St.Louis,MO.Chapter11-13.APOSTOLOPOULOU,E.,