scholarly journals An evaluation of antibiotic prescribing patterns in adult intensive care units in a private hospital in KwaZulu-Natal

2015 ◽  
Vol 30 (1) ◽  
pp. 17-22 ◽  
Author(s):  
Dipika Chunnilall ◽  
Abdool Peer ◽  
Indirani Naidoo ◽  
Sabiha Essack
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Private Hospital ◽  
Prescribing Patterns ◽  
Antibiotic Prescribing ◽  
Kwazulu Natal

scholarly journals Inappropriateness of Antibiotic Prescribing in Medical, Surgical and Intensive Care Units: Results of a Multicentre Observational Study

Life ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. 475
Author(s):  
Margherita Macera ◽  
Federica Calò ◽  
Lorenzo Onorato ◽  
Giovanni Di Caprio ◽  
Caterina Monari ◽  
...  
Keyword(s):  
Intensive Care ◽  
Observational Study ◽  
Intensive Care Units ◽  
Case Report Form ◽  
Antibiotic Prescribing ◽  
Duration Of Treatment ◽  
Campania Region ◽  
Stewardship Program ◽  
Surgical Units ◽  
Set Up

The objectives of the present study were to provide a snapshot analysis of antibiotic appropriateness in two hospitals in Southern Italy in three specific areas, surgical, medical and intensive care, and to evaluate the risk factors associated with inappropriateness in antimicrobial prescriptions. We conducted a multicentre observational study in two hospitals in the Campania region. We collected data of all patients admitted on the day of evaluation to antibiotic therapy or prophylaxis through a case report form. The primary outcome was to assess the inappropriateness of antibiotic prescribing, related to the spectrum, dose, route of administration and duration of treatment—in particular, to assess whether there was a difference in the adequacy of the prescriptive practice in the medical, surgical and intensive sectors. Prescriptive inappropriateness was more frequently observed in surgical units (79.8% of the 104 antimicrobial prescriptions) than in medical units (53.8% of the 65 prescriptions, p = 0.0003) or in intensive care units (64.1% of the 39 prescriptions, p = 0.052). The reasons for the inappropriate antimicrobial prescriptions were similar in the three areas evaluated: antimicrobial unnecessary and antimicrobial not recommended were the most frequent reasons for inappropriateness. Not participating in an antimicrobial stewardship program (ASP) was identified as a factor associated with inappropriate antimicrobial prescriptions in medical and surgical units, but not in Intensive Care Units (ICUs). ASPs may enhance the appropriateness of antimicrobial prescriptions especially in medical and surgical units. In ICUs, specific programs able to limit empirical therapies and encourage the collection of microbiological samples may be useful to set up targeted therapies and to design antimicrobial protocols.

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.

scholarly journals Níveis de estresse da enfermagem nas unidades de terapia intensiva

2019 ◽  
Vol 13 (3) ◽  
pp. 569
Author(s):  
Reinaldo Dos Santos Moura ◽  
Francisco Joilsom Carvalho Saraiva ◽  
Regina Maria Dos Santos ◽  
Kely Regina Da Silva Lima Rocha ◽  
Vívian Mayara Da Silva Barbosa ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Private Hospital ◽  
Work Conditions ◽  
Cross Sectional Study ◽  
Team Work ◽  
Working Environment ◽  
Hospital Services ◽  
Cross Sectional ◽  
Terapia Intensiva

RESUMO Objetivo: descrever os níveis de estresse entre os profissionais de Enfermagem de nível médio nas unidades de terapia intensiva adulto de alguns serviços hospitalares privados. Método: trata-se de um estudo quantitativo, analítico e transversal, em três serviços hospitalares privados. Aplicaram-se dois questionários, analisando-os dados por meio da estatística analítica. Apresentam-se os resultados em forma de tabelas. Resultados: revela-se que, dos 72 participantes, a maioria (95%) era composta de técnicos de Enfermagem, do gênero feminino (52,8%), de adultos jovens (27,8%) e casada (54,2%). Verificou-se, além do escore de estresse moderado (70,8%), que é mais provável que um profissional que apresente essa sintomatologia possa desencadear um alto nível de estresse laboral. Conclusão: averiguaram-se uma taxa significativa de estresse e de absenteísmo, que o ambiente laboral exerce situações tensiogênicas frequentes e que, pela má remuneração salarial, esses profissionais assumem múltiplas jornadas de trabalho que não cessam nos seus domicílios. Descritores: Equipe de Enfermagem; Condições de Trabalho; Esgotamento Emocional; Enfermagem do Trabalho; Unidades de Terapia Intensiva; Risco Ocupacional.ABSTRACT Objective: to describe the levels of stress among nursing professionals in the adult intensive care units of some private hospital services. Method: this is a quantitative, analytical and cross-sectional study in three private hospital services. Two questionnaires were applied, analyzing them by means of analytical statistics. The results are presented in the form of tables. Results: it was found that of the 72 participants, the majority (95%) were Nursing technicians, female (52.8%), young adults (27.8%) and married women (54.2%). In addition to the moderate stress score (70.8%), it is more likely that a professional presenting this symptomatology could trigger a high level of work stress. Conclusion: a significant rate of stress and absenteeism was verified, that the working environment exerts frequent tensiogenic situations and that, due to the poor salary, these professionals take on multiple workdays that do not cease at home. Descriptors: Nursing team; Work conditions; Emotional Exhaustion; Nursing work; Intensive Care Units; Occupational Risk.RESUMEN Objetivo: describir los niveles de estrés entre los profesionales de enfermería de nivel medio en las unidades de terapia intensiva adulto de algunos servicios hospitalarios privados. Método: se trata de un estudio cuantitativo, analítico y transversal, en tres servicios hospitalarios privados. Se aplicaron dos cuestionarios, analizando los datos por medio de la estadística analítica. Se presentan los resultados en forma de tablas. Resultados: se revela que, de los 72 participantes, la mayoría (95%) estaba compuesta de técnicos de Enfermería, del género femenino (52,8%), de adultos jóvenes (27,8%) y casada (54,2%). Se verificó, además de la puntuación de estrés moderado (70,8%), que es más probable que un profesional que presente esta sintomatología pueda desencadenar un alto nivel de estrés laboral. Conclusión: se verificó una tasa significativa de estrés y de absentismo, que el ambiente laboral ejerce situaciones tensiogénicas frecuentes y que, por la mala remuneración salarial, esos profesionales asumen múltiples jornadas de trabajo que no cesan en sus domicilios. Descriptores: Grupo de Enfermería; Condiciones de Trabajo; Agotamiento Profesional; Enfermería del Trabajo; Unidades de Cuidados Intensivos; Riesgos Laborales.  

scholarly journals Clinical Vignettes Provide an Understanding of Antibiotic Prescribing Practices in Neonatal Intensive Care Units

2011 ◽  
Vol 32 (6) ◽  
pp. 597-602 ◽  
Author(s):  
Sameer Patel ◽  
Timothy Landers ◽  
Elaine Larson ◽  
Theoklis Zaoutis ◽  
Patricia Delamora ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Tertiary Care ◽  
Prophylactic Antibiotic ◽  
Generation Cephalosporin ◽  
Neonatal Intensive Care Units ◽  
Antibiotic Prescribing ◽  
Prescribing Practices ◽  
Clinical Vignettes

Objective.To use clinical vignettes to understand antimicrobial prescribing practices in neonatal intensive care units (NICUs).Design.Vignette-based survey.Setting.Four tertiary care NICUs.Participants.Antibiotic prescribers in NICUs.Methods.Clinicians from 4 tertiary care NICUs completed an anonymous survey containing 12 vignettes that described empiric, targeted, or prophylactic antibiotic use. Responses were compared with Centers for Disease Control and Prevention guidelines for appropriate use.Results.Overall, 161 (59% of 271 eligible respondents) completed the survey, 37% of whom had worked in NICUs for 7 or more years. Respondents were more likely to appropriately identify use of targeted therapy for methicillin-susceptible Staphylococcus aureus, that is, use of oxacillin rather than vancomycin, than for Escherichia coli, that is, use of first-generation rather than third-generation cephalosporin, (P < .01). Increased experience significantly predicted appropriate prescribing (P = .02 ). The proportion of respondents choosing appropriate duration of postsurgical prophylaxis (P < .01) and treatment for necrotizing enterocolitis differed by study site (P = .03).Conclusions.The survey provides insight into antibiotic prescribing practices and informs the development of future antibiotic stewardship interventions for NICUs.

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