Simulation training to improve aseptic non-touch technique and success during intravenous cannulation—effect on hospital-acquired blood stream infection and knowledge retention after 6 months: The snowball effect theory

2020 ◽  
pp. 112972982093820
Author(s):  
Bharathi Balachander ◽  
Deepa Rajesh ◽  
Bonita Viona Pinto ◽  
Sofia Stevens ◽  
Suman Rao PN
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Knowledge Retention ◽  
Blood Stream ◽  
Simulation Based ◽  
Post Test ◽  
The Mean ◽  
Hospital Acquired

Background: Intravenous cannulation is a common procedure and a valuable skill in the neonatal intensive care unit. Standardized procedure and personnel training are needed in the unit to prevent hospital-acquired blood stream infections. Hence, we evaluated the effect of training using a low-fidelity simulation on the improvement of the aseptic non-touch technique during intravenous cannulation and knowledge retention after 6 months. Methods: The study was conducted in a tertiary care neonatal unit from June 2017 to July 2018. All the staff nurses and junior resident doctors posted in the neonatal intensive care were included in the study. A protocol and checklist score sheet was developed. The score sheet consisted of 23 items with a total score of 46. Participants were expected to obtain a minimum of 80%. A pre-test was conducted initially, followed by a formal training and then a post-test. The NITA newborn venous access mannequin was used to facilitate the training. A re-training for new nurses was conducted after 6 months. Data were analyzed using paired t-test. Results: A total of 29 doctors and nurses were enrolled in the training. The mean pre-test score was 29.93 compared to 42.66 in the post-test scores (mean difference 12.24(95% confidence interval: 9.39–16.05), p < 0.01. The mean scores were higher when the simulation was conducted after 6 months. There was a significant decline in blood stream infection rates from 5.5 to 1.65 per 1000 patient days (p = 0.05). Conclusion: Simulation-based training of health care personnel is a good modality to improve aseptic non-touch technique during intravenous cannulation in the neonatal intensive care unit. Simulation-based training also helps in knowledge retention and standardization of training procedures.

scholarly journals Hospital-Acquired Blood Stream Infection in an Adult Intensive Care Unit

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Jeffrey Harte ◽  
Germander Soothill ◽  
John Glynn David Samuel ◽  
Laurence Sharifi ◽  
Mary White
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Blood Stream Infection ◽  
Case Series ◽  
Blood Stream ◽  
Apache Ii Score ◽  
Invasive Procedures ◽  
Adult Intensive Care Unit ◽  
Hospital Acquired

Background. Hospital-acquired blood stream infections are a common and serious complication in critically ill patients. Methods. A retrospective case series was undertaken investigating the incidence and causes of bacteraemia in an adult intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results. 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit-acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients who developed bacteraemia was greater than that of those who did not (19.8 versus 16.8, respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%; this is in contrast to the mortality rate in our unit as 27.2%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures (9 out of 13 isolates) than in intensive care units reported in other studies. Conclusion. Critical-care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive-care setting, particularly in patients who have undergone invasive procedures.

Investigation and Control of an Outbreak of Enterobacter aerogenes Bloodstream Infection in a Neonatal Intensive Care Unit in Fiji

2009 ◽  
Vol 30 (8) ◽  
pp. 797-800 ◽  
Author(s):  
Swastika A. Narayan ◽  
Jacob L. Kool ◽  
Miriama Vakololoma ◽  
Andrew C. Steer ◽  
Amelita Mejia ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Normal Saline ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Enterobacter Aerogenes ◽  
Blood Stream ◽  
Single Use ◽  
And Control

Ten neonates developed blood stream infection with extended-spectrum β-lactamase-producing Enterobacter aerogenes in a neonatal intensive care unit in Fiji. The source of the outbreak was traced to a bag of contaminated normal saline in the ward, which was used for multiple patients. All isolates recovered from patients were indistinguishable from the bacteria recovered from the normal saline by pulsed-field gel electrophoresis. The outbreak was controlled using simple infection control practices such as reinforcement of strict hand hygiene policy, provision of single use vials of normal saline, and strict aseptic technique for injections.

scholarly journals Hospital Acquired Blood Stream Infection in an Adult Intensive Care Unit: a Retrospective Case Series

2020 ◽  
Author(s):  
Jeffrey Harte ◽  
Germander Soothill ◽  
Jack Samuel ◽  
Laurence Sharifi ◽  
Mary White
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Blood Stream Infection ◽  
Case Series ◽  
Blood Stream ◽  
Apache Ii Score ◽  
Invasive Procedures ◽  
Retrospective Case ◽  
Retrospective Case Series ◽  
Hospital Acquired

Abstract Introduction: Hospital acquired blood stream infections are a common and serious complication in critically ill patients. Methods: A retrospective case series was undertaken investigating the incidence and causes of bacteraemia on an intensive care unit with a high proportion of postoperative cardiothoracic surgical and oncology patients. Results: 405 eligible patients were admitted to the intensive care unit over the course of nine months. 12 of these patients developed a unit acquired blood stream infection. The average Acute Physiology And Chronic Health Evaluation II (APACHE II) score of patients, who developed bacteraemia was greater than those who did not (19.8 versus 16.8 respectively). The risk of developing bacteraemia was associated with intubation and higher rates of invasive procedures. The mortality rate amongst the group of patients that developed bacteraemia was 33%. There was a higher proportion of Gram-negative bacteria isolated on blood cultures than in intensive care units reported in other studies.Conclusion: Critical care patients are at risk of secondary bloodstream infection. This study highlights the importance of measures to reduce the risk of infection in the intensive care setting particularly in patients who have undergone invasive procedures.

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