scholarly journals Device associated infections among neonates in neonatal intensive care units: a single unit survey study in Cairo, Egypt

2020 ◽  
Vol 7 (4) ◽  
pp. 739
Author(s):  
Mohamed Farouk M. Ibrahim ◽  
Hanem Abdullah Mohamed ◽  
May Abdelfattah ◽  
Sara S. ElTatawy
Keyword(s):  
Intensive Care ◽  
Hand Hygiene ◽  
Hospital Stay ◽  
Neonatal Intensive Care ◽  
Blood Stream Infection ◽  
Length Of Hospital Stay ◽  
Blood Stream ◽  
Central Line ◽  
Survey Study ◽  
P Value

Background: Device Associated Infection (DAI) namely Ventilator Associated Pneumonia (VAP) and Central Line Associated Blood Stream Infection (CLABSI) is one of the challenges for both neonatal nurses and doctors. Aims of the study were 1) Assess the rate of DAI occurrence among neonates, 2) explore the relationship between DAI rates and certain risk factors such as nurse patient ratio, hand hygiene practice, gestational age (GA), weight, and length of hospital stay among neonates.Methods: Descriptive correlational survey research design. Sample: All neonates admitted in twelve months-duration were included (total number 1090 neonates). Nurses and doctors were observed for compliance to adequate hand hygiene technique. Tools: 1) Center for Disease Control (CDC) criteria to calculate DAI rates, 2) Hand hygiene five points checklist 3) Review of neonates charts to collect data as weight, GA 4) Ballard score and 5) nurse/patient ratio.Results: 24 neonates developed DAI, high significant negative correlations between DAI and infants’ weight, GA, nurse/patient ratio and overall compliance to hand hygiene techniques were reported (p-value ≤0.05). Length of hospital stay, inadequate hand hygiene technique had strong positive correlations with DAI rate (p-value ≤0.05).Conclusions: Factors that could affect DAI were infant’s weight, GA, length of hospital stay, inadequate hand hygiene technique and nurse/patient ratio. Recommendations: implementation of infection control programs to raise nurses as well as physicians’ compliance to adequate hand hygiene technique and increase number of nurses in the Neonatal Intensive Care Unit (NICU) per shift.

Inpatient Peripherally Inserted Central Venous Catheter Complications: Should Peripherally Inserted Central Catheter Lines be Placed in the Intensive Care Unit Setting?

2017 ◽  
Vol 83 (8) ◽  
pp. 925-927 ◽  
Author(s):  
Michael Martyak ◽  
Ishraq Kabir ◽  
Rebecca Britt
Keyword(s):  
Intensive Care Unit ◽  
Interventional Radiology ◽  
Intensive Care ◽  
Infection Rate ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Complication Rates ◽  
Central Venous ◽  
Icu Patients

Peripherally inserted central venous catheters (PICCs) are now commonly used for central access in the intensive care unit (ICU) setting; however, there is a paucity of data evaluating the complication rates associated with these lines. We performed a retrospective review of all PICCs placed in the inpatient setting at our institution during a 1-year period from January 2013 to December 2013. These were divided into two groups: those placed at the bedside in the ICU and those placed by interventional radiology in non-ICU patients. Data regarding infectious and thrombotic complications were collected and evaluated. During the study period, 1209 PICC line placements met inclusion criteria and were evaluated; 1038 were placed by interventional radiology in non-ICU patients, and 171 were placed at the bedside in ICU patients. The combined thrombotic and central line associated blood stream infection rate was 6.17 per cent in the non-ICU group and 10.53 per cent in the ICU group (P = 0.035). The thrombotic complication rate was 5.88 per cent in the non-ICU group and 7.60 per cent in the ICU group (P = 0.38), whereas the central line associated blood stream infection rate was 0.29 per cent in the non-ICU group and 2.92 per cent in the ICU group (P = 0.002). This study seems to suggest that PICC lines placed at the bedside in the ICU setting are associated with higher complication rates, in particular infectious complications, than those placed by interventional radiology in non-ICU patients. The routine placement of PICC lines in the ICU settings needs to be reevaluated given these findings.

Nursing Specialty Certification and Nursing-Sensitive Patient Outcomes in the Intensive Care Unit

2010 ◽  
Vol 19 (6) ◽  
pp. 490-498 ◽  
Author(s):  
Greta Krapohl ◽  
Milisa Manojlovich ◽  
Richard Redman ◽  
Lingling Zhang
Keyword(s):  
Intensive Care ◽  
Patient Outcomes ◽  
Blood Stream Infection ◽  
Organizational Factors ◽  
Blood Stream ◽  
Central Line ◽  
Outcome Data ◽  
Work Place ◽  
Work Effectiveness ◽  
Workplace Empowerment

Background To the public and to individual nurses, certification usually means expert, high-quality, competent nursing care. Little research, however, has yielded results that support, or refute, any differences in clinical practice between certified and noncertified nurses. Objectives To determine whether the proportion of certified nurses on a unit is associated with the rate of nurse-sensitive patient outcomes. Methods A nonexperimental, correlational, descriptive design was used to anonymously survey 866 nurses working in 25 intensive care units in Southeast Michigan. The Conditions for Work Effectiveness Questionnaire-II was used to measure workplace empowerment, and an additional question was asked about certification status. Outcome data were simultaneously collected on 3 nurse-sensitive patient outcomes: (1) rate of central line catheter-associated blood stream infection, (2) rate of ventilator-associated pneumonia, and (3) prevalence of pressure ulcers. Data were aggregated and analyzed at the unit level. Results No significant relationship was found between the proportion of certified nurses on a unit and patients’ outcomes. The association between nurses’ perception of overall work-place empowerment and certification, however, was positive and statistically significant (r=.397, P=.05). Conclusions Although a link between certification and nurse-sensitive outcomes was not established, the association between workplace empowerment and the proportion of certified nurses on a unit underscores the importance of organizational factors in the promotion of nursing certification.

scholarly journals Incidence and Determinants of Health Care Associated Blood Stream Infection at a Neonatal Intensive Care Unit in Ujjain, India: A Prospective Cohort Study

2017 ◽  
Author(s):  
Mamta Dhaneria ◽  
Sachin Jain ◽  
Poonam Singh ◽  
Aditya Mathur ◽  
Cecilia Stålsby Lundborg ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care ◽  
Neonatal Intensive Care ◽  
Late Onset ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Extended Spectrum Beta Lactamase ◽  
Medical College ◽  
Resource Limited ◽  
Causative Agents

Very little is known about healthcare-associated infections (HAIs) in neonatal intensive care units (NICUs) in resource-limited settings including, India. The aim of this prospective study was to determine the prevalence, onset, risk factors and causative agents of laboratory confirmed blood stream (LBCI) as a HAI in a level-2 NICU at RD Gardi Medical College, Ujjain, India. The diagnosis of HAI was established using the Centre for Disease Control, USA criteria. A predesigned questionnaire containing risk factors associated with BSHAI was filled. A total of 150 neonates (43% preterm) were included in the study. The incidence of LBCI was 31%; 56% of which was late onset sepsis. The independent risk factors for LBCI were: preterm (Odds Ratio OR 3.22), duration of NICU stay more than 14 days (OR 2.38), chorioamnionitis in the mother (OR 18.48), neonate born through meconium stained amniotic fluid (OR 4.53), mal-presentation (OR 10.58), endotracheal intubation (OR 11.60), umbilical catheterization (OR 15.11), HAI due to ventilator-associated pneumonia (VAP) (OR 11.88). Initiation of minimal enteral nutrition was protective (OR 0.15). The predominant causative organisms were Gram-negative pathogens (58%). Among Klebsiella spp. and E. coli isolates, 73 and 80%, respectively were identified as extended-spectrum beta-lactamase producers. The results can be used to identify high-risk neonates for LBCI.

scholarly journals Cytomegalovirus Infection among Infants in Neonatal Intensive Care Units, California, 2005 to 2016

2019 ◽  
Vol 37 (02) ◽  
pp. 146-150
Author(s):  
Chinh Tran ◽  
Mihoko V. Bennett ◽  
Jeffrey B. Gould ◽  
Henry C. Lee ◽  
Tatiana M. Lanzieri
Keyword(s):  
Intensive Care ◽  
Birth Weight ◽  
Hospital Stay ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Very Low Birth Weight ◽  
Length Of Hospital Stay ◽  
Neonatal Intensive Care Units ◽  
Cmv Infection ◽  
Vlbw Infants

Aim The main purpose of this article is to assess trends in cytomegalovirus (CMV) infection reported among infants in California neonatal intensive care units (NICUs) during 2005 to 2016. Study Design The California Perinatal Quality Care Collaborative collects data on all very low birth weight (VLBW, birth weight ≤ 1,500 g) and acutely ill infants > 1,500 g, representing 92% of NICUs in California. We compared clinical characteristics and length of hospital stay among infants with and without reported CMV infection (CMV-positive viral culture or polymerase chain reaction). Results During 2005 to 2016, CMV infection was reported in 174 VLBW infants and 145 infants > 1,500 g, or 2.7 (range: 1.5–4.7) and 1.2 (range: 0.8–1.7) per 1,000 infants, respectively (no significant annual trend). Among infants > 1,500 g, 12 (8%) versus 4,928 (4%) of those reported with versus without CMV infection died (p < 0.05). The median hospital stay was significantly longer among infants reported with versus without CMV infection for both VLBW infants (98 vs. 46 days) and infants > 1,500 g (61 vs. 14 days) (p < 0.001). Conclusion Reports of CMV infection remained stable over a 12-year period. Although we were not able to assess whether infection was congenital or postnatal, CMV infection among infants > 1,500 g was associated with increased mortality.

Device associated healthcare associated infections in a pediatric intensive care unit of a Tertiary Care Hospital, Pakistan.

2021 ◽  
Vol 28 (03) ◽  
pp. 338-343
Author(s):  
Shah Ali Ahmed ◽  
Anwarul Haque ◽  
Qalab Abbas ◽  
Humaira Jurair ◽  
Zohra Qamar ud Din ◽  
...  
Keyword(s):  
Intensive Care ◽  
Blood Stream Infection ◽  
Tertiary Care ◽  
Pediatric Intensive Care ◽  
Blood Stream ◽  
Central Line ◽  
Cross Sectional Study ◽  
University Hospital ◽  
Care Hospital ◽  
Cross Sectional

Objective: To determine the frequency of Ventilator associated Pneumonia (VAP), Central Line Associated Blood Stream Infection (CLABSI) and Catheter Associated Urinary Tract infection (CAUTI) by using standardized criteria established by Center of disease control and prevention. Study Design: Cross-sectional study. Setting: PICU of Aga Khan University Hospital (AKUH). Period: (August 2015 to January 2016). Material & Methods: Data was collected on a pre-coded proforma. Data was entered and analyzed through SPSS. Results: 156 patients were enrolled. 102 (65.4%) were male. Mean age was 57.59 months. Mean length of stay was 5.6 days. Patient and Device days were 546 and 958 respectively. Device utilization ratio was 0.56. Four Device associated infections (DAI) were identified during study period with a DAI Rate of 4.17 per 1000 device days. All DAI were CLABSIs. Enterococcus was the most frequent bacterial isolate. Conclusion: DAI are highly prevalent in low resource countries, especially in intensive care areas including PICUs. In our setup, CLABSI are increasing while VAP and CAUTI are decreasing.

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