scholarly journals Device associated –health care associated infections monitoring, prevention and cost assessment at intensive care unit of University Hospital in Poland (2015–2017)

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Wieslawa Duszynska ◽  
Victor Daniel Rosenthal ◽  
Aleksander Szczesny ◽  
Katarzyna Zajaczkowska ◽  
Michal Fulek ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Acinetobacter Baumannii ◽  
Compliance Rate ◽  
University Teaching ◽  
University Hospital ◽  
Incidence Density ◽  
Infection Group ◽  
Health Care Associated Infections

Abstract Background Device-associated health care-associated infections (DA-HAIs) in intensive care unit (ICU) patients constitute a major therapeutic issue complicating the regular hospitalisation process and having influence on patients’ condition, length of hospitalisation, mortality and therapy cost. Methods The study involved all patients treated > 48 h at ICU of the Medical University Teaching Hospital (Poland) from 1.01.2015 to 31.12.2017. The study showed the surveillance and prevention of DA-HAIs on International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) 3 online platform according to methodology of the INICC multidimensional approach (IMA). Results During study period 252 HAIs were found in 1353 (549F/804M) patients and 14,700 patient-days of hospitalisation. The crude infections rate and incidence density of DA-HAIs was 18.69% and 17.49 ± 2.56 /1000 patient-days. Incidence density of ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI) and catheter-associated urinary tract infection (CA-UTI) per 1000 device-days were 12.63 ± 1.49, 1.83 ± 0.65 and 6.5 ± 1.2, respectively. VAP(137) constituted 54.4% of HAIs, whereas CA-UTI(91) 36%, CLA-BSI(24) 9.6%.The most common pathogens in VAP and CA-UTI was multidrug-resistant (MDR) Acinetobacter baumannii (57 and 31%), and methicillin-resistant Staphylococcus epidermidis (MRSE) in CLA-BSI (45%). MDR Gram negative bacteria (GNB) 159 were responsible for 63.09% of HAIs. The length of hospitalisation of patients with a single DA-HAI at ICU was 21(14–33) days, while without infections it was 6.0 (3–11) days; p = 0.0001. The mortality rates in the hospital-acquired infection group and no infection group were 26.1% vs 26.9%; p = 0.838; OR 0.9633;95% CI (0.6733–1.3782). Extra cost of therapy caused by one ICU acquired HAI was US$ 11,475/Euro 10,035. Hand hygiene standards compliance rate was 64.7%, while VAP, CLA-BSI bundles compliance ranges were 96.2–76.8 and 29–100, respectively. Conclusions DA-HAIs was diagnosed at nearly 1/5 of patients. They were more frequent than in European Centre Disease Control report (except for CLA-BSI), more frequent than the USA CDC report, yet less frequent than in limited-resource countries (except for CA-UTI). They prolonged the hospitalisation period at ICU and generated substantial additional costs of treatment with no influence on mortality. The Acinetobacter baumannii MDR infections were the most problematic therapeutic issue. DA-HAIs preventive methods compliance rate needs improvement.

scholarly journals Prevalence of multidrug-resistant Acinetobacter baumannii in a critical care setting: A tertiary teaching hospital experience

2021 ◽  
Vol 9 ◽  
pp. 205031212110011
Author(s):  
Thabit Alotaibi ◽  
Abdulrhman Abuhaimed ◽  
Mohammed Alshahrani ◽  
Ahmed Albdelhady ◽  
Yousef Almubarak ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Mortality Rate ◽  
Acinetobacter Baumannii ◽  
Care Setting ◽  
Multidrug Resistant ◽  
University Hospital ◽  
Published Data ◽  
Tertiary Teaching ◽  
The Mean

Background: The management of Acinetobacter baumannii infection is considered a challenge especially in an intensive care setting. The resistance rate makes it difficult to manage and is believed to lead to higher mortality. We aim to investigate the prevalence of Acinetobacter baumannii and explore how different antibiotic regimens could impact patient outcomes as there are no available published data to reflect our population in our region. Methods: We conducted a retrospective review of all infected adult patients admitted to the intensive care unit at King Fahad University Hospital with a confirmed laboratory diagnosis of Acinetobacter baumannii from 1 January 2013 until 31 December 2017. Positive cultures were obtained from the microbiology department and those meeting the inclusive criteria were selected. Variables were analyzed using descriptive analysis and cross-tabulation. Results were further reviewed and audited by blinded co-authors. Results: A comprehensive review of data identified 198 patients with Acinetobacter baumannii. The prevalence of Acinetobacter baumannii is 3.37%, and the overall mortality rate is 40.81%. Our sample consisted mainly of male patients, that is, 68.7%, with a mean age of 49 years, and the mean age of female patients was 56 years. The mean age of survivors was less than that of non-survivors, that is, 44.95 years of age. We observed that prior antibiotic use was higher in non-survivors compared to survivors. From the review of treatment provided for patients infected with Acinetobacter baumannii, 65 were treated with colistin alone, 18 were treated with carbapenems, and 22 were treated with a combination of both carbapenems and colistin. The mean length of stay of Acinetobacter baumannii–infected patients was 20.25 days. We found that the survival rates among patients who received carbapenems were higher compared to those who received colistin. Conclusion: We believe that multidrug-resistant Acinetobacter baumannii is prevalent and associated with a higher mortality rate and represents a challenging case for every intensive care unit physician. Further prospective studies are needed.

scholarly journals Chlorhexidine Gluconate Bathing Program to Reduce Health Care–Associated Infections in Both Critically Ill and Non–Critically Ill Patients

2021 ◽  
Vol 41 (5) ◽  
pp. e1-e8
Author(s):  
Leigh Chapman ◽  
Lisa Hargett ◽  
Theresa Anderson ◽  
Jacqueline Galluzzo ◽  
Paul Zimand
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Chlorhexidine Gluconate ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Telemetry Unit ◽  
Health Care Associated Infections ◽  
The Impact

Background Critical care nurses take care of patients with complicated, comorbid, and compromised conditions. These patients are at risk for health care–associated infections, which affect patients’ lives and health care systems in various ways. Objective To gauge the impact of routinely bathing patients with 4% chlorhexidine gluconate solution on the incidence of health care–associated infections in a medical-surgical intensive care unit and a postoperative telemetry unit; to outline the framework for a hospital-wide presurgical chlorhexidine gluconate bathing program and share the results. Methods A standard bathing protocol using a 4% chlorhexidine gluconate solution was developed. The protocol included time studies, training, monitoring, and surveillance of health care–associated infections. Results Consistent patient bathing with 4% chlorhexidine gluconate was associated with a 52% reduction in health care–associated infections in a medical-surgical intensive care unit. The same program in a postoperative telemetry unit yielded a 45% reduction in health care–associated infections. Conclusion A comprehensive daily 4% chlorhexidine gluconate bathing program can be implemented with standardized protocols and detailed instructions and can significantly reduce the incidence of health care–associated infections in intensive care unit and non–intensive care unit hospital settings.

Health care-associated infections in the intensive care unit of Saqr Hospital, Ras Al Khaimah, in 2013

2014 ◽  
Vol 7 (2) ◽  
pp. 267
Author(s):  
ManalMahmoud Sami ◽  
YousirM Abdulgafor ◽  
WaedYasser Al Zobi ◽  
RandM Abdulgafor ◽  
RashaA Salama ◽  
...  
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Health Care Associated Infections

scholarly journals Hand hygiene knowledge, perception and practice of healthcare workers in a Turkish university hospital intensive care unit

2019 ◽  
Vol 13 (08) ◽  
pp. 744-747 ◽  
Author(s):  
Uluhan Sili ◽  
Pinar Ay ◽  
Huseyin Bilgin ◽  
Seyhan Hidiroglu ◽  
Volkan Korten
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Hand Hygiene ◽  
Healthcare Workers ◽  
Compliance Rate ◽  
Cross Sectional Study ◽  
University Hospital ◽  
World Health ◽  
Training Methods ◽  
Cross Sectional

Introduction: While improvement of hand hygiene (HH) compliance is considered as the best approach to reduce healthcare-associated infections, the instructional interventions in HH among healthcare workers of intensive care unit (ICU) of our hospital was not successful enough. The following study was conducted to evaluate HH knowledge, perception, practice and effectiveness of the trainings among healthcare workers of ICU in our hospital. Methodology: A cross-sectional study was conducted in the ICU containing 8 medical and 16 surgical beds with 284 filled questionnaires about HH knowledge and 1187 observed opportunities for HH compliance. Results: Overall observed HH compliance rate was 40.6%; lowest compliance was 21.7% for “before clean/aseptic procedure” indication and highest compliance was 68.6% for “after touching a patient” indication. Although > 90% healthcare workers correctly identified the World Health Organization’s five indications for HH, 82 – 85% failed to recognize non-indications, i.e. when it was not necessary to perform HH. Our study showed that 15.1% of healthcare workers neither received nor felt the need for HH training. Conclusions: Despite regular HH trainings, healthcare workers could not differentiate when HH was not required which suggested failure to understand HH rationale. This may explain poor HH compliance rates. A systematic study is needed in order to find out the reasons behind of this noncompliance and improve HH training methods for educating healthcare workers.

scholarly journals Barriers to reporting clinical errors in operating theatres and intensive care units of a university hospital: a qualitative study

BMC Nursing ◽  
2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Sedighe Ghobadian ◽  
Mansour Zahiri ◽  
Behnaz Dindamal ◽  
Hossein Dargahi ◽  
Farzad Faraji-Khiavi
Keyword(s):  
Health Care ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Qualitative Study ◽  
Qualitative Content Analysis ◽  
Operating Theatre ◽  
University Hospital ◽  
Care Staff ◽  
Health Care Staff ◽  
Organizational Problems

Abstract Background Clinical errors are one of the challenges of health care in different countries, and obtaining accurate statistics regarding clinical errors in most countries is a difficult process which varies from one study to another. The current study was conducted to identify barriers to reporting clinical errors in the operating theatre and the intensive care unit of a university hospital. Methods This qualitative study was conducted in the operating theatre and intensive care unit of a university hospital. Data collection was conducted through semi-structured interviews with health care staff, senior doctors, and surgical assistants. Data analysis was carried out through listening to the recorded interviews and developing transcripts of the interviews. Meaning units were identified and codified based on the type of discussion. Then, codes which had a common concept were grouped under one category. Finally, the codes and designated categories were analysed, discussed and confirmed by a panel of four experts of qualitative content analysis, and the main existing problems were identified and derived. Results Barriers to reporting clinical errors were extracted in two themes: individual problems and organizational problems. Individual problems included 4 categories and 12 codes and organizational problems included 6 categories and 17 codes. The results showed that in the majority of cases, nurses expressed their desire to change the current prevailing attitudes in the workplace while doctors expected the officials to implement reform policies regarding clinical errors in university hospitals. Conclusion In order to alleviate the barriers to reporting clinical errors, both individual and organizational problems should be addressed and resolved. At an individual level, training nursing and medical teams on error recognition is recommended. In order to solve organizational problems, on the other hand, the process of reporting clinical errors should be improved as far as the nursing team is concerned, but when it comes to the medical team, addressing legal loopholes should be given full consideration.

scholarly journals An outbreak of Acinetobacter baumannii septicemia in a neonatal intensive care unit of a university hospital in Brazil

2005 ◽  
Vol 9 (4) ◽  
pp. 301-309 ◽  
Author(s):  
Denise von Dolinger de Brito ◽  
Elias José Oliveira ◽  
Vânia O. Steffen Abdallah ◽  
Ana Lúcia da Costa Darini ◽  
Paulo P. Gontijo Filho
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Neonatal Intensive Care Unit ◽  
Acinetobacter Baumannii ◽  
Neonatal Intensive Care ◽  
University Hospital
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