Assessing the Burden ofAcinetobacter baumanniiin Maryland: A Statewide Cross-Sectional Period Prevalence Survey

Objective.To determine the prevalence ofAcinetobacter baumannii, an important healthcare-associated pathogen, among mechanically ventilated patients in Maryland.Design.The Maryland MDRO Prevention Collaborative performed a statewide cross-sectional active surveillance survey of mechanically ventilated patients residing in acute care and long-term care (LTC) facilities. Surveillance cultures (sputum and perianal) were obtained from all mechanically ventilated inpatients at participating facilities during a 2-week period.Setting.All healthcare facilities in Maryland that provide care for mechanically ventilated patients were invited to participate.Patients.Mechanically ventilated patients, known to be at high risk for colonization and infection withA. baumannii, were included.Results.Seventy percent (40/57) of all eligible healthcare facilities participated in the survey, representing both acute care (n= 30) and LTC (n= 10) facilities in all geographic regions of Maryland. Surveillance cultures were obtained from 92% (358/390) of eligible Patients.A. baumanniiwas identified in 34% of all mechanically ventilated patients in Maryland; multidrug-resistantA. baumanniiwas found in 27% of all Patients.A. baumanniiwas detected in at least 1 patient in 49% of participating facilities; 100% of LTC facilities had at least 1 patient with A.baumannii, compared with 31% of acute care facilities.A. baumanniiwas identified from all facilities in which 10 or more patients were sampled.Conclusions.A.baumanniiis common among mechanically ventilated patients in both acute care and LTC facilities throughout Maryland, with a high proportion of isolates demonstrating multidrug resistance.

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CUIDADOS BUCAIS EM PACIENTES VENTILADOS MECANICAMENTE: CONHECIMENTO DE ENFERMEIROS DE UM HOSPITAL ESCOLA

Enfermagem em Foco ◽

10.21675/2357-707x.2017.v8.n4.932 ◽

2018 ◽

Vol 8 (4) ◽

Author(s):

Gérsica Sampaio Silva ◽

Fernanda Alves Ferreira Gonçalves ◽

Bárbara Ribeiro Miquelin Bueno ◽

Georlucya Kátia Da Silva Ferreira ◽

Ludmila Pinheiro Da Silva ◽

...

Keyword(s):

Oral Hygiene ◽

Oral Care ◽

Cross Sectional Study ◽

Cross Sectional ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Complicating Factors ◽

Materials Used ◽

Ventilated Patients

Objetivo: Avaliar o conhecimento acerca dos cuidados bucais realizados por enfermeiros a pacientes ventilados mecanicamente. Método: Estudo transversal, realizado em um hospital escola de Goiânia/Goiás. A coleta de dados deu-se por meio de questionário estruturado. Resultados: Os enfermeiros conhecem as medidas recomendadas sobre higiene bucal. Os fatores dificultadores encontrados foram a falta de pessoal (21,7%), falta de tempo (16,7%) e trabalhos burocráticos (15%). Contudo ainda existem lacunas no que se refere a produtos e materiais utilizados na higiene bucal. Conclusão: As Lacunas e os fatores dificultadores sinalizados nesse estudo merecem reflexão, como forma de avaliar a qualidade do cuidado oferecido.Descritores: Biofilme; Higiene Bucal; Cuidados de enfermagem.ORAL CARE IN MECHANICALLY VENTILATED PATIENTS: KNOWLEDGE OF NURSES FROM A SCHOOL HOSPITALObjective: To evaluate the knowledge about oral care performed by nurses in mechanically ventilated patients. Methods: a cross-sectional study, conducted in a teaching hospital of Goiania/Goias. The data collection was performed by means of a structured questionnaire. Results: The nurses know the measures recommended on oral hygiene. The complicating factors found were the lack of personnel (21.7%), lack of time (16.7%) and work on tape (15%). However there are still gaps in relation to products and materials used in oral hygiene. Conclusion: The gaps and the factors complicating factors indicated in this study deserve consideration, as a means of evaluating the quality of care offered.Keywords: Biofilm; Oral hygiene; Nursing care.CUIDADO ORAL EN PACIENTES CON VENTILACIÓN MECÁNICA: EL CONOCIMIENTO DE LAS ENFERMERAS DEL HOSPITAL ESCUELAObjetivo: Evaluar el conocimiento sobre el cuidado bucal realizadas por enfermeras en pacientes ventilados mecánicamente. Métodos: Estudio transversal, realizado en un hospital de Goiania y Goias. La recolección de datos se realizó por medio de un cuestionario estructurado. Resultados: Las enfermeras saben las medidas recomendadas en la higiene bucal. Los factores encontrados fueron la falta de personal (21,7%), la falta de tiempo (16,7%) y trabajar en la cinta (15%). Sin embargo todavía hay lagunas en relación con los productos y los materiales utilizados en la higiene bucal. Conclusión: Las brechas y los factores factores indicados en este estudio merecen consideración, como medio de evaluar la calidad de la atención ofrecida.Palabras clave: Biofilme; Higiene Bucal; Atención de Enfermería.

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2480. Communication During Patient Transfers: Describing Gaps in the Infectious Status Information Pipeline

Open Forum Infectious Diseases ◽

10.1093/ofid/ofz360.2158 ◽

2019 ◽

Vol 6 (Supplement_2) ◽

pp. S859-S859

Author(s):

Jeanmarie Mayer ◽

Roberta Horth ◽

Madison Todd ◽

Randon Gruninger ◽

Allyn K Nakashima

Keyword(s):

Acute Care ◽

Skilled Nursing Facility ◽

Multidrug Resistant ◽

The State ◽

Cross Sectional ◽

Skilled Nursing ◽

Patient Transfers ◽

Healthcare Facilities ◽

Additional Information ◽

Infection Preventionists

Abstract Background Fragmented communication of patients’ infectious status across healthcare networks impact regional spread of multidrug-resistant organisms (MDRO). This study aimed to quantify gaps in communication of patient MDRO status across Utah healthcare facilities and to identify opportunities to improve. Methods This is a cross-sectional retrospective mixed-methods study of patient transfers from three purposively selected healthcare facilities: an acute care (ACF), long-term acute care (LTAC), and skilled-nursing facility (SNF). Patients with known MDRO transferred out of these facilities over the previous week were identified in bimonthly samples spanning 2 months. Infection preventionists and admission nurses from facilities receiving these patients were interviewed. Results Of 293 patients transferred to another facility, 13% (n = 38) had an active infection or colonization with an MDRO. These 38 patients were transferred to 26 healthcare facilities within the state (4 ACF, 3 LTAC, 19 SNF). Gram-negative organisms with resistance to a carbapenem accounted for 15.8% of those transferred with an MDRO. There was no documentation of the state infection control transfer form (ICTF) at the sending facility for 68.5% of MDRO patient transfers. Of 22 admitting nurses interviewed, 19 (86.4%) did not receive an ICTF, 6 (27.3%) received no communication regarding patients’ infectious status, and 11 (50%) had to contact the sending facility for additional information. Moreover, 18.2% of patients had not been put on appropriate precautions. Several nurses expressed confusion with MDRO definitions and lack of guidance regarding care of MDRO colonized patients. Among infection preventionists asked about general MDRO transfers (n = 26), 26.9% reported that communication on infectious status of MDRO patients was received in under 40% of incoming transfers. When asked about a planned statewide MDRO registry, 80.8% felt that such a system would be actively searched at their facility, and 96.2% felt that a system that pushes out alerts would be useful. Conclusion Given the widespread gaps in communication of infectious status of patients with MDROs transferred across the healthcare facilities sampled, efforts to standardize and improve MDRO communication in the region is warranted. Disclosures All authors: No reported disclosures.

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IMPACT OF VENTILATOR MODEL ON MORTALITY: A RETROSPECTIVE CROSS-SECTIONAL STUDY IN 147 MECHANICALLY VENTILATED PATIENTS WITH COVID-19 ARDS

CHEST Journal ◽

10.1016/j.chest.2020.08.581 ◽

2020 ◽

Vol 158 (4) ◽

pp. A617

Author(s):

Christian Castaneda ◽

Christina Jee Ah Rhee ◽

Albert Magh ◽

Christine Eng ◽

Jack Mann ◽

...

Keyword(s):

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

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Outcomes after Long-Term Acute Care: An Analysis of 133 Mechanically Ventilated Patients.

Cardiopulmonary Physical Therapy Journal ◽

10.1097/01823246-199910040-00009 ◽

1999 ◽

Vol 10 (4) ◽

pp. 153

Author(s):

S S Carson ◽

P B Bach ◽

L Brzozowski ◽

A. Leff

Keyword(s):

Acute Care ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Ventilated Patients

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Acute Emergence of Elizabethkingia meningoseptica Infection among Mechanically Ventilated Patients in a Long-Term Acute Care Facility

Infection Control and Hospital Epidemiology ◽

10.1086/649223 ◽

2010 ◽

Vol 31 (1) ◽

pp. 54-58 ◽

Cited By ~ 21

Author(s):

Kingsley N. Weaver ◽

Roderick C. Jones ◽

Rosemary Albright ◽

Yolanda Thomas ◽

Carlos H. Zambrano ◽

...

Keyword(s):

Acute Care ◽

Acute Care Hospital ◽

Care Facility ◽

Acute Care Hospitals ◽

Care Hospital ◽

Mechanically Ventilated ◽

Mechanically Ventilated Patients ◽

Elizabethkingia Meningoseptica ◽

Ventilated Patients

Objective.To describe an outbreak of infection associated with an infrequently implicated pathogen, Elizabethkingia meningoseptica, in an increasingly prominent setting for health care of severely ill patients, the long-term acute care hospital.Design.Outbreak investigation.Setting.Long-term acute care hospital with 55 patients, most of whom were mechanically ventilated.Methods.We defined a case as E. meningoseptica isolated from any patient specimen source from December 2007 through April 2008, conducted an investigation of case patients, obtained environmental specimens, and performed microbiologic testing.Results.Nineteen patients had E. meningoseptica infection, and 8 died. All case patients had been admitted with respiratory failure that required mechanical ventilation. Among the 8 individuals who died, the time from collection of the first specimen positive for E. meningoseptica to death ranged from 6 to 43 days (median, 16 days). Environmental sampling was performed on 106 surfaces; E. meningoseptica was isolated from only one swab. Three related pulsed-field gel electrophoresis patterns were identified in patient isolates; the environmental isolate yielded a fourth, unrelated pattern.Conclusion.Long-term acute care hospitals with mechanically ventilated patients could serve as an important transmission setting for E. meningoseptica. This multidrug-resistant bacterium could pose additional risk when patients are transferred between long-term acute care hospitals and acute care hospitals.

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