scholarly journals National Estimates of Central Line–Associated Bloodstream Infections in Critical Care Patients

2013 ◽  
Vol 34 (6) ◽  
pp. 547-554 ◽  
Author(s):  
Matthew E. Wise ◽  
R. Douglas Scott ◽  
James M. Baggs ◽  
Jonathan R. Edwards ◽  
Katherine D. Ellingson ◽  
...  
Keyword(s):  
United States ◽  
Critical Care ◽  
Bloodstream Infections ◽  
The United States ◽  
Central Line ◽  
Teaching Hospitals ◽  
Annual Number ◽  
Network Systems ◽  
Substantial Progress ◽  
Critical Care Patients

Objective.Recent studies have demonstrated that central line-associated bloodstream infections (CLABSIs) are preventable through implementation of evidence-based prevention practices. Hospitals have reported CLABSI data to the Centers for Disease Control and Prevention (CDC) since the 1970s, providing an opportunity to characterize the national impact of CLABSIs over time. Our objective was to describe changes in the annual number of CLABSIs in critical care patients in the United States.Design.Monte Carlo simulation.Setting.US acute care hospitals.Patients.Nonneonatal critical care patients.Methods.We obtained administrative data on patient-days for nearly all US hospitals and applied CLABSI rates from the National Nosocomial Infections Surveillance and the National Healthcare Safety Network systems to estimate the annual number of CLABSIs in critical care patients nationally during the period 1990–2010 and the number of CLABSIs prevented since 1990.Results.We estimated that there were between 462,000 and 636,000 CLABSIs in nonneonatal critical care patients in the United States during 1990–2010. CLABSI rate reductions led to between 104,000 and 198,000 fewer CLABSIs than would have occurred if rates had remained unchanged since 1990. There were 15,000 hospital-onset CLABSIs in nonneonatal critical care patients in 2010; 70% occurred in medium and large teaching hospitals.Conclusions.Substantial progress has been made in reducing the occurrence of CLABSIs in US critical care patients over the past 2 decades. The concentration of critical care CLABSIs in medium and large teaching hospitals suggests that a targeted approach may be warranted to continue achieving reductions in critical care CLABSIs nationally.

Tracheostomy

2019 ◽  
pp. 850-854
Author(s):  
Saba Ghorab ◽  
David G. Lott
Keyword(s):  
United States ◽  
Mechanical Ventilation ◽  
Critical Care ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Prolonged Mechanical Ventilation ◽  
The United States ◽  
Critical Care Patients

Tracheostomy is a procedure where a conduit is created between the skin and the trachea. Tracheostomy is one of the most frequent procedures undertaken in critically ill patients. Each year, approximately 10% of critical care patients in the United States require a tracheostomy, most often for prolonged mechanical ventilation.

Preventing Peripheral Intravenous Line Infections: Recommendations for Healthcare Facilities

2009 ◽  
Vol 14 (4) ◽  
pp. 187-190 ◽  
Author(s):  
Nancy Moureau
Keyword(s):  
United States ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
The United States ◽  
Central Line ◽  
Intravenous Catheter ◽  
Central Lines ◽  
Healthcare Facilities ◽  
Peripheral Intravenous Catheter ◽  
Intravascular Devices

Intravascular catheters are indispensable tools in acute care, but with the benefits come the risk of local or systemic Healthcare Acquired Infections (HAIs). In fact, more than 250,000–500,000 intravascular-related bloodstream infections occur in the United States each year with resulting mortality rates of 12%–25%. (Maki, Kluger & Crnich, 2006; CDC, 2002). While bloodstream infections related to the use of peripheral lines may not occur as often as they do with central lines, they do occur. Although most studies focus on central catheter-related bloodstream infections due to their greater documented prevalence and severity, some studies have evaluated the prevalence of peripheral intravenous catheter-associated bloodstream infections. In 2006 Maki reviewed 200 studies that prospectively examined the risk of Bloodstream Infections (BSIs) associated with intravascular devices over a forty year period. The infection rate with peripheral intravenous catheters was 0.5 per 1000 catheter days. Though the frequency of peripheral intravenous catheter-associated infections is lower than with other intravascular devices, absolute numbers of patients affected can be significant with more than 330 million peripheral catheters sold each year in the United States (Millennium Research Group, 2006). Some doctors are stressing the need to use a peripheral line versus early placement of a central line with the rationale to reduce infection rates. Multiple national and international guidelines advocate a number of simple, yet highly effective procedures to reduce risk of central venous catheter infections. Some of these same guidelines should be applied as standards for peripheral catheters. By standardizing protocols across all types of catheter insertions, safety is ensured in reducing infections and ultimately improving patient care.

scholarly journals Impact of Critical Care Consultation Requests for Avoidable Central Venous Catheters on Medical-Surgical Units

2020 ◽  
Vol 41 (S1) ◽  
pp. s258-s258
Author(s):  
Madhuri Tirumandas ◽  
Theresa Madaline ◽  
Gregory David Weston ◽  
Ruchika Jain ◽  
Jamie Figueredo
Keyword(s):  
Critical Care ◽  
High Risk ◽  
Medical Center ◽  
Academic Medical Center ◽  
Retrospective Chart Review ◽  
Bloodstream Infections ◽  
Central Line ◽  
Central Venous Catheters ◽  
High Risk Population ◽  
Central Venous

Background: Although central-line–associated bloodstream infections (CLABSI) in US hospitals have improved in the last decade, ~30,100 CLABSIs occur annually.1,2 Central venous catheters (CVC) carry a high risk of infections and should be limited to appropriate clinical indications.6,7 Montefiore Medical Center, a large, urban, academic medical center in the Bronx, serves a high-risk population with multiple comobidities.8–11 Despite this, the critical care medicine (CCM) team is often consulted to place a CVC when a peripheral intravenous line (PIV) cannot be obtained by nurses or primary providers. We evaluated the volume of CCM consultation requests for avoidable CVCs and related CLABSIs. Methods: Retrospective chart review was performed for patients with CCM consultation requests for CVC placement between July and October 2019. The indication for CVC, type of catheter inserted or recommended, and NHSN data were used to identify CLABSIs. CVCs were considered avoidable if a PIV was used for the stated indication and duration of therapy, with no anatomical contraindications to PIV in nonemergencies, according to the Michigan Appropriateness Guide for Intravenous Catheters (MAGIC).6Results: Of 229 total CCM consults, 4 (18%) requests were for CVC placement; 21 consultations (9%) were requested for avoidable CVCs. Of 40 CVC requests, 18 (45%) resulted in CVC placement by the CCM team, 4 (10%) were deferred for nonurgent PICC by interventional radiology, and 18 (45%) were deferred in favor of PIV or no IV. Indications for CVC insertion included emergent chemotherapy (n = 8, 44%) and dialysis (n = 3, 16%), vasopressors (n = 3, 16%), antibiotics (n = 2, 11%) and blood transfusion (n = 2, 11%). Of 18 CVCs, 9 (50%) were potentially avoidable: 2 short-term antibiotics and rest for nonemergent indications; 2 blood transfusions, 1 dialysis, 2 chemotherapy and 2 vasopressors. Between July and October 2019, 6 CLABSIs occurred in CVCs placed by the CCM team; in 3 of 6 CLABSI events (50%), the CVC was avoidable. Conclusions: More than half of consultation requests to the CCM team for CVCs are avoidable, and they disproportionately contribute to CLABSI events. Alternatives for intravenous access could potentially avoid 9% of CCM consultations and 50% of CLABSIs in CCM-inserted CVCs on medical-surgical wards.Funding: NoneDisclosures: None

scholarly journals Estimates of the Annual Number of Clinically Recognized Pregnancies in the United States, 1981-1991

1999 ◽  
Vol 149 (11) ◽  
pp. 1025-1029 ◽  
Author(s):  
M. Saraiya ◽  
C. J. Berg ◽  
H. Shulman ◽  
C. A. Green ◽  
H. K. Atrash
Keyword(s):  
United States ◽  
The United States ◽  
Annual Number

A Paradigm Shift in Healthcare Innovation as Revealed by Research Trends in Mobile Health: A Bibliometric Analysis. (Preprint)

2021 ◽  
Author(s):  
Jianfei Cao ◽  
Yeongjoo Lim ◽  
Shintaro Sengoku ◽  
Xitong Guo ◽  
Kota Kodama
Keyword(s):  
United States ◽  
Health Policy ◽  
Bibliometric Analysis ◽  
The United States ◽  
Research Trends ◽  
Annual Number ◽  
Public Healthcare ◽  
Growth Trend ◽  
Number Of Publications ◽  
Research Hotspots

BACKGROUND Smartphones have become an integral part of our lives with their unprecedented popularity and diversification of applications. The continuous upgrading of information technology has also enabled smartphones to display great potential in the field of healthcare. OBJECTIVE This study aimed to clarify the future research direction of mHealth by analyzing its research trends and latest research hotspots. METHODS This study collected mHealth-related literature published between 2000 and 2020 from the Web of Science database. Descriptive statistics of the literature were computed using Excel software. The publication trends of mHealth research were determined by analyzing the annual number of publications in the literature and annual number of publications categorized based on different countries. Finally, this study used the VOSviewer tool to construct visualization network maps of country/region collaborations and author keyword co-occurrences, and overlay visualization maps of the average publication year of author keywords to analyze the hotspots and research trends in mHealth research. RESULTS In this study, 12,593 mHealth-related research articles published between 2000 and 2020 were collected. The results showed an exponential growth trend in the number of annual publications in mHealth literature. The United States remained the leading contributor to the literature in this area (5,294/12,593, 42%), well ahead of other countries/regions. Other countries/regions also showed a clear trend of annual increases in the number of publications in mHealth literature. Regarding cooperation between countries, the four countries with the largest number of publications, the United States, the United Kingdom, Canada, and Australia, were found to cooperate more closely. The rest of the countries/regions showed a clear geographical pattern of cooperation. The keyword co-occurrence analysis of the top 100 authors formed five clusters, namely: development of mHealth medical technology and its application in various diseases, use of mHealth technology to improve basic public health and health policy, mHealth self-health testing and management in daily life, adolescent use of mHealth, and mHealth in mental health. The research trends revealed a gradual shift in mHealth research from health policy and improving public healthcare to the development and social application of mHealth technologies. CONCLUSIONS To the best of our knowledge, the most current bibliometric analysis dates back to 2016. However, the number of mHealth researches published between 2017 and 2020 exceeds the previous total. Therefore, the results of this study shed light on the latest research hotspots and research trends in mHealth research. These findings provide a useful overview of the development of the field; they may also serve as a valuable reference and provide guidance for other researchers in the field.

Activity of Oritavancin Against Gram-positive Pathogens Causing Bloodstream Infections in the United States Over 10 Years: Focus on Drug-Resistant Enterococcal Subsets (2010-2019)

2021 ◽  
Author(s):  
Cecilia G. Carvalhaes ◽  
Helio S. Sader ◽  
Jennifer M. Streit ◽  
Mariana Castanheira ◽  
Rodrigo E. Mendes
Keyword(s):  
United States ◽  
Staphylococcus Aureus ◽  
Enterococcus Faecium ◽  
Bloodstream Infections ◽  
The United States ◽  
Drug Resistant ◽  
Gram Positive ◽  
Methicillin Resistant ◽  
Vancomycin Resistant ◽  
Over Time

Oritavancin displayed potent and stable activity (MIC 90 range, 0.06-0.5 mg/L) over time (2010-2019) against Gram-positive pathogens causing bloodstream infections, including methicillin-resistant Staphylococcus aureus and resistant subsets of Enterococcus spp. Daptomycin and linezolid were also active against methicillin-resistant S. aureus and vancomycin-resistant Enterococcus . Only oritavancin and linezolid remained active against Enterococcus faecium isolates displaying an elevated daptomycin MIC (i.e., 2-4 mg/L). Proportions of methicillin-resistant S. aureus and vancomycin-resistant Enterococcus within the respective S. aureus and enterococcal populations decreased over this period.

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