Lack of Statistical Power

PEDIATRICS ◽  
1987 ◽  
Vol 79 (2) ◽  
pp. 313-314
Author(s):  
JOHN M. PASCOE
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Sample Size ◽  
Pediatric Intensive Care Unit ◽  
Infection Rate ◽  
Nosocomial Infections ◽  
Statistical Power ◽  
Pediatric Intensive Care ◽  
Negative Trial

To the Editor.— Dr Donowitz described an interesting research project in which the efficacy of overgown use in the prevention of pediatric intensive care unit nosocomial infection was examined.1 He concludes that "overgowns were an expensive and ineffective method of preventing or decreasing nosocomial infections."1 Although Dr Donowitz may be correct, his inattention to sample size and statistical power in this negative trial makes his argument less than compelling. Given the nosocomial "base rate" of about 10% without gowns, the detection of an infection rate difference of 50% between the nongown and gown subgroups (α = .05, β = .2) would require a sample size of about 500 in each subgroup.2

Evaluation of a New Method of Detection of Nosocomial Infection in the Pediatric Intensive Care Unit: The Infection Control Sentinel Sheet System

1989 ◽  
Vol 10 (11) ◽  
pp. 515-520 ◽  
Author(s):  
E.L. Ford-Jones ◽  
C.M. Mindorff ◽  
E. Pollock ◽  
R. Milner ◽  
D. Bohn ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Pediatric Intensive Care Unit ◽  
Nosocomial Infections ◽  
Chart Review ◽  
Pediatric Intensive Care ◽  
Full Time

AbstractTo improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.

Failure of the Overgown to Prevent Nosocomial Infection in a Pediatric Intensive Care Unit

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 35-38
Author(s):  
Leigh G. Donowitz
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Pediatric Intensive Care Unit ◽  
Infection Rate ◽  
Pediatric Intensive Care ◽  
Infection Rates ◽  
Intravascular Catheter ◽  
Catheter Colonization ◽  
The Mean

In a pediatric intensive care unit we conducted a 1-year prospective study of 454 patients to determine whether wearing a gown decreased the overall nosocomial infection rate, incidence of intravascular catheter colonization, breaks in handwashing technique, and traffic. The overall infection rate was 26 (13%) of 198 admissions during the gown-wearing periods v 23 (9%) of 256 admissions for the periods when gowns were not worn (P < .25). Of 348 intravascular catheter tips cultured 16 (4.6%) were colonized during gown-wearing periods compared with 21 (6.3%) of 330 when no gowns were worn (P < .25). Of 78 patient contacts 54 (69%) were followed by no handwashing during gown-wearing periods and 59 (70%) of 84 contacts were followed by no handwashing during periods when no gowns were worn. The mean occurrence of visits per patient per hour and total visits per hour differed between gown-wearing and no-gown-wearing periods by analysis of variance, P < .01 and P < .005, respectively. Although traffic was decreased during periods of gown use, overgowns are an expensive, ineffective method of decreasing nosocomial infection rates, vascular catheter colonization rates, and breaks in handwashing technique.

Use of the Pediatric Risk of Mortality score to predict nosocomial infection in a pediatric intensive care unit

1991 ◽  
Vol 19 (2) ◽  
pp. 160-165 ◽  
Author(s):  
EVELYN POLLOCK ◽  
E. LEE FORD-JONES ◽  
MARY COREY ◽  
GEOFFREY BARKER ◽  
CATHY M. MINDORFF ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Pediatric Intensive Care Unit ◽  
Pediatric Intensive Care ◽  
Risk Of Mortality

scholarly journals Nosocomial infections in a pediatric intensive care unit of a developing country: NHSN surveillance

2012 ◽  
Vol 45 (4) ◽  
pp. 475-479 ◽  
Author(s):  
Juliana Pena Porto ◽  
Orlando Cesar Mantese ◽  
Aglai Arantes ◽  
Claudete Freitas ◽  
Paulo Pinto Gontijo Filho ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Developing Country ◽  
Pediatric Intensive Care Unit ◽  
Nosocomial Infections ◽  
Staphylococcus Epidermidis ◽  
Pediatric Intensive Care ◽  
Venous Catheter ◽  
Extrinsic Factors ◽  
A Prospective Study

INTRODUCTION: This study aimed to determine the epidemiology of the three most common nosocomial infections (NI), namely, sepsis, pneumonia, and urinary tract infection (UTI), in a pediatric intensive care unit (PICU) in a developing country and to define the risk factors associated with NI. METHODS: We performed a prospective study on the incidence of NI in a single PICU, between August 2009 and August 2010. Active surveillance by National Healthcare Safety Network (NHSN) was conducted in the unit and children with NI (cases) were compared with a group (matched controls) in a case-control fashion. RESULTS: We analyzed 172 patients; 22.1% had NI, 71.1% of whom acquired it in the unit. The incidence densities of sepsis, pneumonia, and UTI per 1,000 patients/day were 17.9, 11.4, and 4.3, respectively. The most common agents in sepsis were Enterococcus faecalis and Escherichia coli (18% each); Staphylococcus epidermidis was isolated in 13% of cases. In pneumonias Staphylococcus aureus was the most common cause (3.2%), and in UTI the most frequent agents were yeasts (33.3%). The presence of NI was associated with a long period of hospitalization, use of invasive devices (central venous catheter, nasogastric tube), and use of antibiotics. The last two were independent factors for NI. CONCLUSIONS: The incidence of NI acquired in this unit was high and was associated with extrinsic factors.

Nosocomial Infections in the Pediatric Intensive Care Unit: Epidemiology and Control

2006 ◽  
pp. 1394-1421 ◽  
Author(s):  
Jacques Lacroix ◽  
France Gauvin ◽  
Peter Skippen ◽  
Peter Cox ◽  
Joanne M. Langley ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Pediatric Intensive Care Unit ◽  
Nosocomial Infections ◽  
Pediatric Intensive Care ◽  
And Control
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