Effectiveness of Surveillance of Central Catheter-Related Bloodstream Infection in an ICU in Korea

2001 ◽  
Vol 22 (7) ◽  
pp. 433-436 ◽  
Author(s):  
Sunmi Yoo ◽  
Mina Ha ◽  
Daeok Choi ◽  
Hyunjoo Pai
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Intervention Period ◽  
Active Infection ◽  
Surgical Intensive Care ◽  
And Control

AbstractObjective:To determine whether surveillance and infection control interventions decrease the incidence of catheter-related (CR) bloodstream infections (BSIs) in Korea.Setting:A medical-surgical intensive care unit (ICU) of a university hospital in Korea.Design:The CR infection rate of the intervention period was compared to that of historical controls for a 4-month period.Patients:All patients with a central venous catheter in the intensive care unit (ICU) from October 1998 to January 1999.Methods:Active infection control programs were initiated during the intervention period. Data collected included patient characteristics, risk factors of CR infection, and the microbiology laboratory results. Laboratory-proven CR infection rates were compared between the intervention group and control group.Results:304 catheters were inserted into 248 patients. The intervention group and the control group showed similar characteristics, but more patients in the intervention group received steroid therapy, and subclavian insertion was more common in the intervention group. CR BSI occurred in 1.3 per 1,000 catheter-days in the intervention group and 4.2 in the control group (binomial test, P=.14). CR infections were associated with the duration of ICU admission by multivariate logistic regression.Conclusions:The data suggested that an active infection surveillance and control program could reduce the rate of CR BSI in an ICU.

Feasibility of a Mindfulness-Based Intervention for Surgical Intensive Care Unit Personnel

2017 ◽  
Vol 26 (1) ◽  
pp. 10-18 ◽  
Author(s):  
Beth A. Steinberg ◽  
Maryanna Klatt ◽  
Anne-Marie Duchemin
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Work Engagement ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Negative Effects ◽  
Surgical Intensive Care ◽  
Utrecht Work Engagement Scale

Background Surgical intensive care unit personnel are exposed to catastrophic situations as they care for seriously injured or ill patients. Few interventions have been developed to reduce the negative effects of work stress in this environment. Objective This pilot study evaluated the feasibility of a workplace intervention for increasing resilience to stress. The intervention was implemented within the unique constraints characteristic of surgical intensive care units. Methods Participants were randomly assigned to an intervention or control group. The mindfulness-based intervention included meditation, mild yoga movement, and music and was conducted in a group format 1 hour a week for 8 weeks in a surgical intensive care unit during work hours. Assessments were performed 1 week before and 1 week after the intervention. Results The intervention was well received, with a 97% overall retention rate and 100% retention in the intervention group. Work satisfaction, measured with the Utrecht Work Engagement Scale, increased significantly in the intervention group with no change in the control group. Negative correlations were found between the vigor subscale scores of the Utrecht Work Engagement Scale and scores for emotional exhaustion on the Maslach Burnout Inventory and scores for burnout on the Professional Quality of Life scale. Participants rated recognizing their stress response as a main benefit of the intervention. Conclusion Workplace group interventions aimed at decreasing the negative effects of stress can be applied within hospital intensive care units. Despite many constraints, attendance at weekly sessions was high. Institutional support was critical for implementation of this program.

scholarly journals Using simulation and inter-professional education to teach infection prevention during resuscitation

2021 ◽  
Vol 6 (1) ◽  
pp. 93-108
Author(s):  
Kah Wei Tan ◽  
Hwee Kuan Ong ◽  
Un Sam Mok
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Professional Education ◽  
Infection Prevention ◽  
Teaching Method ◽  
Intervention Group ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care

Introduction: During resuscitations, healthcare professionals (HCPs) find balancing the need for timely resuscitation and adherence to infection prevention (IP) measures difficult. This study explored the effects of an innovative teaching method, using in-situ simulation and inter-professional education to enhance compliance to IP through better inter-professional collaboration. Methods: The study was conducted in the Surgical Intensive Care Unit (SICU) in a 1200-beds teaching hospital. HCPs working in the SICU were conveniently allocated to the intervention or control group based on their work roster. The intervention group attended an in-situ simulated scenario on managing cardiac arrest in an infectious patient. The control group completed the standard institution-wide infection control eLearning module. Outcomes measured were: (a) attitudes towards inter-professional teamwork [TeamSTEPPS Teamwork Attitudes Questionnaire (TAQ)], (b) infection prevention knowledge test, (c) self-evaluated confidence in dealing with infectious patients and (d) intensive care unit (ICU) audits on infection prevention compliance during actual resuscitations. Results: 40 HCPs were recruited. 29 responded (71%) to the pre- and post-workshop questionnaires. There were no significant differences in the TeamSTEPPS TAQ and infection prevention knowledge score between the groups. However, ICU audits demonstrated a 60% improvement in IP compliance for endotracheal tube insertion and 50% improvement in parenteral medication administration. This may be attributed to the debriefing session where IP staff shared useful tips on compliance to IP measures during resuscitation and identified threats that could deter IP compliance in SICU. Conclusion: Learning infection prevention through simulated inter-professional education (IPE) workshops may lead to increased IP compliance in clinical settings.

Limited Impact of Sustained Simple Feedback Based on Soap and Paper Towel Consumption on the Frequency of Hand Washing in an Adult Intensive Care Unit

2002 ◽  
Vol 23 (3) ◽  
pp. 120-126 ◽  
Author(s):  
Marvin J. Bittner ◽  
Eugene C. Rich ◽  
Paul D. Turner ◽  
William H. Arnold
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Prospective Trial ◽  
Hand Washing ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care ◽  
Adult Intensive Care Unit ◽  
Paper Towel

Objective:To determine whether hand washing would increase with sustained feedback based on measurements of soap and paper towel consumption.Design:Prospective trial with a nonequivalent control group.Setting:Open multibed rooms in the Omaha Veterans Affairs Medical Center's Surgical Intensive Care Unit (SICU) and Medical Intensive Care Unit (MICU).Subjects:Unit staff.Intervention:Every weekday from May 26 through December 8,1998, we recorded daytime soap and paper towel consumption, nurse staffing, and occupied beds in the SICU (intervention unit) and the MICU (control unit) and used these data to calculate estimated hand washing episodes (EHWEs), EHWEs per occupied bed per hour, and patient-to-nurse ratios. In addition, from May 26 through June 26 (baseline period) and from November 2 through December 8 (follow-up period), live observers stationed daily for random 4-hour intervals in the MICU and the SICU counted actual hand washing episodes (CHWEs). The intervention consisted of posting in the SICU, but not in the MICU, a graph showing the weekly EHWEs per occupied bed per hour for the preceding 5 weeks.Results:Directly counted hand washing fell in the SICU from a baseline of 2.68 ± 0.72 (mean ± standard deviation) episodes per occupied bed per hour to 1.92 ± 1.35 in the follow-up period. In the MICU, episodes fell from 2.58 ± 0.95 (baseline) to 1.74 ± 0.69. In the MICU, the withdrawal of live observers was associated with a decrease in estimated episodes from 1.36 ± 0.49 at baseline to 1.01 ± 0.36, with a return to 1.16 ± 0.50 when the observers returned. In the SICU, a similar decrease did not persist throughout a period of feedback. Estimated hand washing correlated negatively with the patient-to-nurse ratio (r= -0.35 for the MICU,r= -0.46 for the SICU).Conclusions:Sustained feedback on hand washing failed to produce a sustained improvement. Live observers were associated with increased hand washing, even when they did not offer feedback. Hand washing decreased when the patient-to-nurse ratio increased.

Epidemiologic, Clinical, and Economic Evaluation of an Outbreak of Clonal Multidrug-ResistantAcinetobacter baumanniiInfection in a Surgical Intensive Care Unit

2007 ◽  
Vol 28 (11) ◽  
pp. 1247-1254 ◽  
Author(s):  
Lisa S. Young ◽  
Allison L. Sabel ◽  
Connie S. Price
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Significant Risk ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Duration Of Hospitalization ◽  
Tract Infections ◽  
Pulsatile Lavage

Objectives.To determine risk factors for acquisition of multidrug-resistant (MDR)Acinetobacter baumanniiinfection during an outbreak, to describe the clinical manifestations of infection, and to ascertain the cost of infection.Design.Case-control study.Setting.Surgical intensive care unit in a 400-bed urban teaching hospital and level 1 trauma center.Patients.Case patients received a diagnosis of infection due toA. baumanniiisolates with a unique pattern of drug resistance (ie, susceptible to imipenem, variably susceptible to aminoglycosides, and resistant to all other antibiotics) between December 1, 2004, and August 31, 2005. Case patients were matched 1 : 1 with concurrently hospitalized control patients. Isolates' genetic relatedness was established by pulsed-field gel electrophoresis.Results.Sixty-seven patients met the inclusion criteria. Case and control patients were similar with respect to age, duration of hospitalization, and Charlson comorbidity score. MDRA. baumanniiinfections included ventilator-associated pneumonia (in 56.7% of patients), bacteremia (in 25.4%), postoperative wound infections (in 25.4%), central venous catheter-associated infections (in 20.9%), and urinary tract infections (in 10.4%). Conditional multiple logistic regression was used to determine statistically significant risk factors on the basis of results from the bivariate analyses. The duration of hospitalization and healthcare charges were modeled by multiple linear regression. Significant risk factors included higher Acute Physiology and Chronic Health Evaluation II score (odds ratio [OR], 1.1 per point increase;P= .06), duration of intubation (OR, 1.4 per day intubated;P<.01), exposure to bronchoscopy (OR, 22.7;P= .03), presence of chronic pulmonary disease (OR, 77.7;P= .02), receipt of fluconazole (OR, 73.3;P<.01), and receipt of levofloxacin (OR, 11.5;P= .02). Case patients had a mean of $60,913 in attributable excess patient charges and a mean of 13 excess hospital days.Interventions.Infection control measures included the following: limitations on the performance of pulsatile lavage wound debridement, the removal of items with upholstered surfaces, and the implementation of contact isolation for patients with suspected MDRA. baumanniiinfection.Conclusions.This large outbreak of infection due to clonal MDRA. baumanniicaused significant morbidity and expense. Aerosolization of MDRA. baumanniiduring pulsatile lavage debridement of infected wounds and during the management of respiratory secretions from colonized and infected patients may promote widespread environmental contamination. Multifaceted infection control interventions were associated with a decrease in the number of MDRA. baumanniiisolates recovered from patients.

scholarly journals Catheter-associated urinary tract infection in a surgical intensive care unit

2015 ◽  
Vol 72 (10) ◽  
pp. 883-888 ◽  
Author(s):  
Jovan Mladenovic ◽  
Milic Veljovic ◽  
Ivo Udovicic ◽  
Srdjan Lazic ◽  
Zeljko Jadranin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Urinary Tract Infection ◽  
Intensive Care ◽  
Urinary Tract ◽  
Tract Infection ◽  
Nosocomial Infections ◽  
Surgical Intensive Care Unit ◽  
Control Group ◽  
Surgical Intensive Care

Background/Aim. Because patients in intensive care units usually have an urinary catheter, the risk of urinary tract infection for these patients is higher than in other patients. The aim of this study was to identify risk factors and causative microrganisms in patients with catheter-associated urinary tract infection (CAUTI) in the Surgical Intensive Care Unit (SICU) during a 6-year period. Methods. All data were collected during prospective surveillance conducted from 2006 to 2011 in the SICU, Military Medical Academy, Belgrade, Serbia. This case control study was performed in patients with nosocomial infections recorded during surveillance. The cases with CAUTIs were identified using the definition of the Center for Disease Control and Prevention. The control group consisted of patients with other nosocomial infections who did not fulfill criteria for CAUTIs according to case definition. Results. We surveyed 1,369 patients representing 13,761 patient days. There were a total of 226 patients with nosocomial infections in the SICU. Of these patients, 64 had CAUTIs as defined in this study, and 162 met the criteria for the control group. Multivariate logistic regression analysis identified two risk factors independently associated to CAUTIs: the duration of having an indwelling catheter (OR = 1.014; 95% CI 1.005-1.024; p = 0.003) and female gender (OR = 2.377; 95%CI 1.278-4.421; p = 0.006). Overall 71 pathogens were isolated from the urine culture of 64 patients with CAUTIs. Candida spp. (28.2%), Pseudomonas aeruginosa (18.3%) and Klebsiella spp. (15.5%) were the most frequently isolated microorganisms. Conclusions. The risk factors and causative microrganisms considering CAUTIs in the SICU must be considered in of planning CAUTIs prevention in this setting.

Effect of Nebulized Eucalyptus for Preventing Ventilator-Associated Pneumonia in Patients under Mechanical Ventilation: A Randomized Double Blind Clinical Trial

2018 ◽  
Author(s):  
HasanAli Karimpour ◽  
Behzad Hematpour ◽  
Saeed Mohammadi ◽  
Javad Aminisaman ◽  
Maryam Mirzaei ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Intervention Group ◽  
Control Group ◽  
Pulmonary Infections ◽  
Double Blind ◽  
Double Blind Clinical Trial ◽  
And Control ◽  
And Staphylococcus Aureus

Abstract Background: Pneumonia caused by the ventilator is the most common acquired infection in the intensive care unit, which increases the morbidity and mortality of the patients. Eucalyptus plant has antiseptic properties. Therefore, the present study investigates the effect of eucalyptus incense on prevention of pneumonia in patients with endotracheal tube in the intensive care unit. Methods: This clinical trial study was performed on 100 patients under ventilation in two intervention and control groups in Imam Reza Hospital, Kermanshah, Iran in 2018. The patients in the intervention group, Eucalyptus solution 2% and in the control group received 10 cc distilled water as an inhaler three times a day. The results of the two groups were compared to the incidence of pulmonary infections based on CPIS criteria and compared with SPSS version 19 software. Results: The incidence of late pneumonia was significantly lower in the intervention group (P=0.02). The onset of pneumonia significantly later in the intervention group than the control group (P=0.01). The prevalence of Klebsiella, Candida albicans, and Staphylococcus aureus was significantly decreased in the intervention group (P=0.02) (P=0.04) (P=0.01). Conclusion: The results of this study showed that eucalyptus inhalation is effective in reducing the incidence of pulmonary infection in patients under ventilation. It is recommended that these products be used to prevent pulmonary infections in these patients.

scholarly journals Evaluation of the increase in invasive device associated infections in cardiovascular surgical intensive care unit

2018 ◽  
Vol 12 (07) ◽  
pp. 508-513
Author(s):  
Esra Kaya Kılıç ◽  
Cemal Bulut ◽  
Muzaffer Çeliköz ◽  
Günay Tuncer Ertem ◽  
Çiğdem Ataman Hatipoğlu ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Infection Control ◽  
Health Care Professionals ◽  
Cardiovascular Surgery ◽  
Control Measures ◽  
Surgical Intensive Care Unit ◽  
Hospital Infections ◽  
Surgical Intensive Care

Introduction: Infections related to the use of invasive instruments leads to the risk of treatment difficulties, prolonged hospitalization, increased health care costs, and increased mortality and morbidity rates. The present study examines the results of an infection surveillance study that showed an increased incidence of infections related to the use of invasive instruments in the cardiovascular surgery intensive care unit of the Ankara Training and Research Hospital and mitigating measures were taken following the surveillance program. Methodology: Compared with previous surveillance data, an increase was observed in the incidence of infections related to the use of invasive instruments in cardiovascular surgery intensive care unit (CVS-ICU) during the first six months of 2014. A research team was formed comprising one infectious diseases and microbiology specialist, one cardiovascular surgeon, and two infection-control nurses. Patient data was collected. The compliance of the surgeons, nurses, and other health care professionals to the infection control measures was evaluated. Results: The rate of ventilator-associated pneumonia was 8.20% and the rate of catheter-associated urinary tract infection was 4.47% in the CVS-ICU. There were missing or inadvertent practices regarding antibiotic prophylaxis, asepsis and antisepsis and isolation measures in patient preparation and patient care before and after the operations. The rate of inappropriate antibiotic as prolonged use was 72%. Conclusions: It is one of the basic tasks to take appropriate measures to prevent outbreaks of hospital infections. It is possible to prevent an outbreak of hospital infections only by the accurate analysis of data and establishing strict infection control procedures.

Successful Eradication of a Monoclonal Strain ofKlebsiella pneumoniaeduring aK. pneumoniaeCarbapenemase-ProducingK. pneumoniaeOutbreak in a Surgical Intensive Care Unit in Miami, Florida

2010 ◽  
Vol 31 (10) ◽  
pp. 1074-1077 ◽  
Author(s):  
L. Silvia Munoz-Price ◽  
Carolina De La Cuesta ◽  
Stephen Adams ◽  
Mary Wyckoff ◽  
Timothy Cleary ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Klebsiella Pneumoniae ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Horizontal Spread ◽  
And Control

We describe the investigation and control of aKlebsiella pneumoniaecarbapenemase-producingK. pneumoniaeoutbreak in a 20-bed surgical intensive care unit during the period from January 1, 2009 through January 1, 2010. Nine patients were either colonized or infected with a monoclonal strain ofK. pneumoniae.The implementation of a bundle of interventions on July 2009 successfully controlled the further horizontal spread of this organism.

scholarly journals Analysis of a new best-practice advisory on time to initiation of antibiotics in surgical intensive care unit patients with septic shock

2018 ◽  
Vol 20 (1) ◽  
pp. 34-39 ◽  
Author(s):  
Tyler Chanas ◽  
David Volles ◽  
Rob Sawyer ◽  
Stephanie Mallow-Corbett
Keyword(s):  
Intensive Care Unit ◽  
Septic Shock ◽  
Intensive Care ◽  
Best Practice ◽  
Surgical Intensive Care Unit ◽  
Antibiotic Administration ◽  
Intervention Period ◽  
Surgical Intensive Care ◽  
Practice Advisory ◽  
Time To Antibiotics

Background Early administration of antibiotics in septic shock is associated with decreased mortality. Promptly identifying sepsis and eliciting a response are necessary to reduce time to antibiotic administration. Methods A best-practice advisory was introduced in the surgical intensive care unit to identify patients with septic shock and promote timely action. The best-practice advisory is triggered by blood culture orders and vasopressor administration within 24 h. The nurse or provider who triggers the alert may send an automatic notification to the intensive care unit resident, clinical pharmacist, and charge nurse, prompting bedside response and closer evaluation. Patients who met best-practice advisory criteria in the surgical intensive care unit from May 2016 through March 2017 were included. Outcomes included changes in antibiotics within 24 h, response to best-practice advisory, and time-to-antibiotics. Time-to-antibiotics was compared between a retrospective pre-intervention period and a six-month prospective post-intervention period defined by launch of the new best-practice advisory in September 2016. Data were analyzed by chi square, Mann–Whitney U, and Kruskal-Wallis. Results During the first six months of best-practice advisory implementation, 191 alerts were triggered by 97 unique patients. Alert notification was transmitted in 79 best-practice advisories (41%), with pharmacist bedside response in 53 (67%). New antibiotics were started within 24 h following 83 best-practice advisories (43%). There was a trend toward decreased time-to-antibiotics following implementation of the best-practice advisory (7.4 vs. 4.2 h, p = 0.057). Compared to the entire cohort, time-to-antibiotics was shorter when the team was notified and when a pharmacist responded to the bedside (4.2 vs. 1.6 vs. 1.2 hours). Conclusions A new best-practice advisory has been effective at eliciting a rapid response and reducing the time-to-antibiotics in surgical intensive care unit patients with septic shock. Team notification and pharmacist response are associated with decreased time-to-antibiotics.

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