Education and performance feedback effect on rates of central vascular catheter–associated bloodstream infections in newborn intensive care units in a private hospital in Colombia

2005 ◽  
Vol 33 (5) ◽  
pp. e76-e77
Author(s):  
W.V. Gómez ◽  
G.R. Vergara ◽  
A.M. Pertuz ◽  
V.D. Rosenthal
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Performance Feedback ◽  
Private Hospital ◽  
Bloodstream Infections ◽  
Feedback Effect ◽  
Newborn Intensive Care ◽  
And Performance

scholarly journals Incidence Of Central Line-associated Bloodstream Infections In Intensive Care Units In A Private Hospital (Cairo, Egypt)

2018 ◽  
Vol 11 (1) ◽  
pp. 562-571
Author(s):  
Amira M. Malek ◽  
Hasnaa A. Abouseif ◽  
Khaled M. Abd Elaziz ◽  
Mohamed F. Allam ◽  
Hoda I. Fahim
Keyword(s):  
Risk Factors ◽  
Heart Failure ◽  
Mechanical Ventilation ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Private Hospital ◽  
Bloodstream Infections ◽  
Central Line ◽  
Incidence Density ◽  
Icu Stay

Objective: The study aimed to measure the incidence, risk factors and most frequent causative organisms of central line-associated bloodstream infections (CLA-BSI) in the Medical/Coronary and Surgical Intensive Care Units (ICUs) at a private hospital. Methods: This prospective study included 499 patients and was conducted between April 2014 and September 2014 in the Medical/Coronary ICU and Surgical ICU of a private hospital in Cairo, Egypt. Results: Approximately 44% of all the patients admitted to the ICUs underwent Central Venous Catheter (CVC) insertion. The overall incidence density rate of CLA-BSI was 6 cases per 1000 central line-days. The central line utilization rate was 0.94 per 1000 patient-days. The mortality rate among cases with CLA-BSI was 16.8% (95% CI: 13.6% – 20.4%) during the study period. Risk factors for CLA-BSI were detected by univariate analysis and included associated co-morbidities such as heart failure, APACHE II scores of >15, an ICU stay of 5 days or more, duration of CVC placement, subclavian insertion of CVCs, and mechanical ventilation. Additionally, logistic regression analysis identified a long ICU stay of 5 days or more, mechanical ventilation and the presence of heart failure as the only significant predictors. Gram-negative bacteria, especially Enterobacter (36.8%: 95% CI: 16.3%– 61.6%), Pseudomonas aeruginosa (21.1%: 95% CI: 16.0% - 45.5%) were the predominant organisms detected in CLA-BSI cases. Conclusion: CLA-BSI is an important cause of mortality in ICU patients. The infection rate is considerably higher than that in recent studies from developed counties, but it is still lower than the rates reported in comparable published studies in Egypt. Strict adherence to the standard infection prevention practices for critically ill patients is highly recommended.

Effect of Education and Performance Feedback on Rates of Catheter-Associated Urinary Tract Infection in Intensive Care Units in Argentina

2004 ◽  
Vol 25 (1) ◽  
pp. 47-50 ◽  
Author(s):  
Victor Daniel Rosenthal ◽  
Sandra Guzman ◽  
Nasia Safdar
Keyword(s):  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Latin American ◽  
Performance Feedback ◽  
Baseline Period ◽  
And Performance ◽  
Catheter Care

AbstractObjective:To evaluate the effect of education and performance feedback regarding compliance with catheter care and handwashing on rates of catheter-associated urinary tract infection (UTI) in intensive care units (ICUs).Setting:Two level III adult ICUs in a private healthcare facility in Argentina.Patients:All adult patients admitted to the study units who had a urinary catheter in place for at least 24 hours.Methods:A prospective, open trial in which rates of catheter-associated UTI determined during a baseline period of active surveillance without education and performance feedback were compared with rates of catheter-associated UTI after imple-menting education and performance feedback.Results:There were 1,779 catheter-days during the baseline period and 5,568 catheter-days during the intervention period. Compliance regarding prevention of compression of the tubing by a leg improved (from 83% to 96%; relative risk [RR], 1.15; 95% confidence interval [CI95], 1.03 to 1.28; P = .01) and so did compliance with handwashing (from 23.1% to 65.2%; RR, 2.82; CI95, 2.49 to 3.20; P<.0001). Catheter-associated UTI rates decreased significantly from 21.3 to 12.39 per 1,000 catheter-days (RR, 0.58; CI95, 0.39 to 0.86; P = .006).Conclusion:Implementing education and performance feedback regarding catheter care measures and handwashing compliance was associated with a significant reduction in catheter-associated UTI rates. Similar programs may help reduce catheter-associated UTI rates in other Latin American hospitals.

scholarly journals The national rate of intensive care units-acquired infections, one-year retrospective study in Iran

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Neda Izadi ◽  
Babak Eshrati ◽  
Yadollah Mehrabi ◽  
Korosh Etemad ◽  
Seyed-Saeed Hashemi-Nazari
Keyword(s):  
Intensive Care ◽  
Tract Infection ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Increased Risk ◽  
Neonatal Icu ◽  
Mortality Causes ◽  
One Year ◽  
Multi Center Study

Abstract Background Hospital-acquired infections (HAIs) in intensive care units (ICUs) are among the avoidable morbidity and mortality causes. This study aimed at investigating the rate of ICU-acquired infections (ICU-AIs) in Iran. Methods For the purpose of this multi-center study, the rate of ICU-AIs calculated based on the data collected through Iranian nosocomial infections surveillance system and hospital information system. The data expanded based on 12 months of the year (13,632 records in terms of “hospital-ward-month”), and then, the last observation carried forward method was used to replace the missing data. Results The mean (standard deviation) age of 52,276 patients with HAIs in the ICUs was 47.37 (30.78) years. The overall rate of ICU-AIs was 96.61 per 1000 patients and 16.82 per 1000 patient-days in Iran’s hospitals. The three main HAIs in the general ICUs were ventilator-associated events (VAE), urinary tract infection (UTI), and pneumonia events & lower respiratory tract infection (PNEU & LRI) infections. The three main HAIs in the internal and surgical ICUs were VAE, UTI, and bloodstream infections/surgical site infections (BSI/SSI). The most prevalent HAIs were BSI, PNEU & LRI and eye, ear, nose, throat, or mouth (EENT) infections in the neonatal ICU and PNEU & LRI, VAE, and BSI in the PICU. Device, catheter, and ventilator-associated infections accounted for 60.96, 18.56, and 39.83% of ICU-AIs, respectively. The ventilator-associated infection rate was 26.29 per 1000 ventilator-days. Based on the Pabon Lasso model, the lowest rates of ICU-AIs (66.95 per 1000 patients and 15.19 patient-days) observed in zone III, the efficient area. Conclusions HAIs are common in the internal ICU wards. In fact, VAE and ventilator-related infections are more prevalent in Iran. HAIs in the ICUs leads to an increased risk of ICU-related mortality. Therefore, to reduce ICU-AIs, the specific and trained personnel must be responsible for the use of the devices (catheter use and ventilators), avoid over use of catheterization when possible, and remove catheters earlier.

Healthcare-Associated Infection in Italy Annual Point-Prevalence Surveys, 2002–2004

2009 ◽  
Vol 30 (7) ◽  
pp. 659-665 ◽  
Author(s):  
Simone Lanini ◽  
William R. Jarvis ◽  
Emanuele Nicastri ◽  
Gaetano Privitera ◽  
Giovanni Gesu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Univariate Analysis ◽  
National Health System ◽  
Bloodstream Infections ◽  
Surgical Site Infections ◽  
Point Prevalence ◽  
Healthcare Associated Infection ◽  
Tract Infections ◽  
Healthcare Associated

Objective.Healthcare-associated infections (HAIs) are an important cause of morbidity and mortality worldwide. During the period from 2002 through 2004, a group of Italian hospitals was recruited to conduct HAI point-prevalence surveys.Design.Three point-prevalence surveys.Methods.A total of 9,609 patients were surveyed.Results.The overall frequency of HAI was 6.7% (645 infections among the 9,609 surveyed patients). The most frequent HAIs were lower respiratory tract infections, which accounted for 35.8% (231 of 645 HAIs) of all HAIs, followed by urinary tract infections (152 [23.6%] of 645 HAIs), bloodstream infections (90 [14.0%] of 645 HAIs), and surgical site infections (79 [12.2%] of 645 HAIs). In both multivariate and univariate analysis, invasive procedures, duration of stay, chemotherapy, trauma, coma, and the location of the hospital were all factors statistically significantly associated with the occurrence of an HAL Enterobacteriaceae were the most common isolates recovered in medical and surgical wards, whereas gram-negative aerobic bacilli were the most common isolates recovered in intensive care units. Approximately one-half of all of the patients surveyed were receiving antibiotics at the time of our study; the most used antibiotic classes were fluoroquinolones in medical wards, cephalosporins in surgical wards, and penicillins and glycopeptides in intensive care units.Conclusion.Our study emphasizes the need for implementing further HAI surveillance to provide the National Health System with proper tools to prevent and manage infection in hospitalized patients.

Risk factors for noncatheter-related Candida bloodstream infections in intensive care units: A multicenter case-control study

2018 ◽  
Vol 57 (6) ◽  
pp. 668-674 ◽  
Author(s):  
Ferhat Arslan ◽  
Hulya Caskurlu ◽  
Sema Sarı ◽  
Hayriye Cankar Dal ◽  
Sema Turan ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Case Control Study ◽  
Absolute Risk ◽  
Subsequent Development ◽  
Bloodstream Infections ◽  
Case Control ◽  
Prior Exposure ◽  
Control Study

Abstract Candida bloodstream infections are associated with high mortality among critically ill patients in intensive care units (ICUs). Studies that explore the risk factors for candidemia may support better patient care in intensive care units. We conducted a retrospective, multicenter case-control study to investigate the risk factors for noncatheter-related Candida bloodstream infections (CBSI) in adult ICUs. Participants selected controls randomly on a 1:1 basis among all noncase patients stayed during the same period in ICUs. Data on 139 cases and 140 controls were deemed eligible. Among the controls, 69 patients died. The stratified Fine-Gray model was used to estimate the subdistribution Hazard ratios. The subdistribution hazards and 95% confidence intervals for final covariates were as follows: prior exposure to antimycotic agents, 2.21 (1.56–3.14); prior exposure to N-acetylcysteine, 0.11 (0.03–0.34) and prior surgical intervention, 1.26 (0.76–2.11). Of the patients, those exposed to antimycotic drugs, 87.1% (54/62) had breakthrough candidemia. Serious renal, hepatic, or hematologic side effects were comparable between patients those exposed and not-exposed to systemic antimycotic drugs. Untargeted administration of antimycotic drugs did not improve survival among candidemic patients (not-exposed, 63.6% [49/77]; exposed % 66.1 [41/62]; P = .899). This study documented that exposure to an antifungal agent is associated with increased the risk of subsequent development of CBSIs among nonneutropenic adult patients admitted to the ICU. Only two centers regularly prescribed N-acetylcysteine. Due to the limited number of subjects, we interpreted the positive effect of N-acetylcysteine on the absolute risk of CBSIs with caution.

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