Infection Control and the Prevention of Nosocomial Infections in the Intensive Care Unit

AbstractTo improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.

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Health professionals difficulties in preventing nosocomial infections

Revista de Enfermagem UFPE on line ◽

10.5205/reuol.790-7179-1-le.0402201018 ◽

2010 ◽

Vol 4 (2) ◽

pp. 587

Author(s):

Márcio Flávio Moura Araújo ◽

Eveline Pinheiro Beserra ◽

Marília Braga Marques ◽

Rosa Aparecida Nogueira Moreira ◽

Thiago Moura Araújo ◽

...

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Infection Control ◽

Nosocomial Infections ◽

Physical Space ◽

Working Environment ◽

University Hospital ◽

High Turnover ◽

Hospital Infection Control ◽

Terapia Intensiva

ABSTRACTObjective: to know the difficulties encountered by professionals working in the Intensive Care Unit before the challenge of controlling nosocomial infections. Methodology: they were participants of the qualitative research nine professionals from the university hospital in June 2009. A semi-structured script was used as an instrument of data collection about possible problems for the control of nosocomial infections and interviews. The results were organized by categorical technique, and then the data were analyzed in light of reference to Morse and Field. The study was approved by the Ethics in Research of the Institute Dr. José Frota, protocol number 86145/08. Results: the main problems in combating the NI were the inadequate physical space, the long working day, combined with high turnover of patients. The lack of infrastructure service in the implementation of a work within appropriate aseptic conditions was also mentioned. Conclusions: it is important the partnership between the intensive care unit along with Committee of the Hospital Infection Control are co-involved in the control and prevention of nosocomial infections. Descriptors: cross infection; infection control; infection control practitioners; quality of health care; intensive care units; working environment; burnout professional.RESUMOObjetivo: conhecer as dificuldades encontradas pelos profissionais que atuam numa Unidade de Terapia Intensiva diante do desafio do controle das infecções hospitalares. Metodologia: estudo qualitativo desenvolvido com nove profissionais de saúde de um hospital escola durante o período de junho de 2009. Adotou-se como instrumento da coleta de dados, entrevistas e roteiro semi-estruturado sobre possíveis problemas detectados para o controle das infecções hospitalares. Os resultados foram organizados pela técnica categorial, em seguida analisados a luz do referencial de Morse e Field. A pesquisa foi autorizada pelo Comitê de Ética em Pesquisa do Instituto Doutor José Frota, protocolo 86145/08. Resultados: o espaço físico inadequado, jornada laboral extensa juntamente com a grande rotatividade de pacientes foram os principais problemas verificados no combate as infecções hospitalares. A falta de infra-estrutura do serviço na implementação de um trabalho dentro de condições assépticas adequadas também foi citado. Conclusões: a parceria entre a unidade de terapia intensiva juntamente com a Comissão de Controle de Infecção Hospitalar é um desafio importante para que ambos sejam co-participantes no controle e prevenção das infecções hospitalares. Descritores: infecção hospitalar; controle de infecções; profissionais controladores de infecção; qualidade da assistência à saúde; unidades de terapia intensiva; ambiente de trabalho; esgotamento profissional.RESUMENObjetivo: conhecer las dificultades encontradas por los profesionales que trabajan en la Unidad de Cuidados Intensivos ante el desafío de controlar las infecciones nosocomiales. Metodologia: los participantes del estudio cualitativo fueron nueve profesionales del hospital universitario durante el mes de junio de 2009. Se utilizó como un instrumento de recolección de datos entrevistas e un guión semi-estructurado acerca de posibles problemas detectados en el control de infecciones nosocomiales. los resultados fueron organizados de acuerdo a la técnica categorial y, a continuación, los datos analizados a la luz del referencial de Morse y Field. El estudio fue aprobado por el Comité de ética en la investigación del Instituto Dr José Frota, protocolo 86145/08. Resultados: la insuficiencia de espacio físico, el largo día de trabajo asociados con la alta rotación de pacientes fueron los principales problemas en la lucha contra las infecciones hospitalares. La falta de serviços de infraestructura en la ejecución de una obra en condiciones adecuadas de asepsia. También se mencionó. Conclusiones: es importante la colaboración entre la unidad de cuidados intensivos, junto con el Comité de Control da Infección Hospitalaria a fin de que ambos sean co-implicados en el control y la prevención de las infecciones hospitalares. Descriptores: infección hospitalaria; control de infecciones; profesionales para control de infecciones; calidad de la atención de salud; unidades de terapia intensiva; ambiente de trabajo; agotamiento profesional.

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Nosocomial infections and microbiological agents in an intensive care unit

Archives of Biological Sciences ◽

10.2298/abs1204357c ◽

2012 ◽

Vol 64 (4) ◽

pp. 1357-1362 ◽

Cited By ~ 1

Author(s):

Gorana Cosic ◽

Jelena Djekic ◽

Smiljana Rajcevic ◽

M. Ristic ◽

N. Ikonic

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Infection Control ◽

Medical Devices ◽

Nosocomial Infections ◽

Healthcare Workers ◽

Hospital Environments ◽

Microbiological Agents ◽

Epidemiological Characteristics

Hospital environments provide a special setting for the interaction of microbiological agents of infection and a host of patients and healthcare workers. Although the basic tenets about the spread of infections in hospital have not changed, new issues have emerged that make infection control more problematic. The aim of this paper was to provide the epidemiological characteristics of nosocomial infections and pathogens among patients in an intensive care unit (ICU), the department with the highest risk of the infections associated with medical devices and healthcare.

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