Zusammenfassung
Intensivpatienten haben aufgrund ihrer Grunderkrankung, häufig invasiver Behandlungstechniken
und nicht selten immunsupprimierender oder Mikrobiota-verändernder Medikation ein
besonders hohes Risiko, eine nosokomiale Infektion zu erleiden. 2016 waren dies laut
European Centre for Disease Prevention and Control 8,4% aller Patienten, die länger
als 2 Tage intensivmedizinisch betreut wurden [1]. Der Beitrag gibt eine Übersicht über wichtige Konzepte und Maßnahmen zur Infektionsprävention
auf der Intensivstation.
Abstract
Secondary to the underlying disease, the need for invasive devices and frequent drug-induced
changes in immunocompetence and microbiota, critically ill patients have a high risk
of suffering nosocomial infections. According to data from the European Centre for
Disease Prevention and Control (ECDC) this affects 8,4% of patients treated in an
ICU for more than 48 hours. Key points of infection prevention are maintenance of
the patientsʼ microbiota and sometimes individually chosen interventions to its restoration
or focused manipulation; development and implementation of care bundles for frequently
used medical devices and invasive treatments (esp. intravenous catheters and invasive
ventilation); adequate staffing not only for physicians, nurses and other medical
staff but also for housekeeping staff, infection surveillance and motivational feedback,
patient empowerment and visitor involvement. Functional building design and well organized
logistics assist in achieving
infection prevention goals by fostering adherence to basic hygiene procedure,
esp. hand hygiene and risk-adjusted use of personal protective equipment. Daily interdisciplinary
rounds following the principles of crew resource management strategies allow the structured
check for unnecessary devices and inadequate use of antiinfective agents in particular
and the discussion of all aspects of the patientsʼ situation in general.
Schlüsselwörter
Intensivstation - Infektionsprävention - Präventionsbündel - Händehygiene - persönliche
Schutzausrüstung
Key words
intensive care unit - infection prevention - infection control bundles - hand hygiene
- personal protective equipment
