A Study of Ventilator-Associated Pneumonia, Surgical Site Infection and Central Line-Associated Bloodstream Infection: Incidence, Outcome, Risk Factors and Measures to Be Taken for Prevention in a Tertiary Care Teaching Hospital

Abstract

Objective: Hospital-associated infections (HAIs) contribute to increased morbidity and mortality, excess healthcare cost, and prolonged hospital stay. This study aims to determine the incidence, risk factors of ventilator associated pneumonia (VAP), surgical site infection (SSI), and central line associated blood stream infection (CLABSI). Together it also assesses the knowledge and practice of nursing staff, physician in understanding HAIs and prevention, also to improve the core knowledge of administration procedures. Methods: A prospective study was conducted among patients, nurses, and doctors of Shamanur Shivashankarapa Institute of Medical Sciences and Research Center hospital for a period of about 6 months. The data were collected, analyzed in terms of both inferential and descriptive statistics. Results: The incidence rate of VAP was found to be 23.61%. VAP was more prominent in males and occurred more in patients who received prolonged ventilation, supine position, and altered mental status, and these risk factors was found to be statistically significant (p<0.05). Acinetobacter was the commonly found causative organism for VAP. The mortality rate in our study was found to be 1 and was reported in early-onset VAP. SSI was more common in females and occurred mostly in elective surgeries with more comorbid conditions and American Society of Anesthesiologists score and these were found to be statistically significant (p<0.05). MRCONS and Escherichia coli were the most common pathogen identified. Mortality rate in our study was zero and 15 patients were clinically well. The incidence rate of CLABSI was found to be 31.25%. Out of 32 centralized patients, only 10 developed CLABSI and is more prominent in males. Staphylococcus aureus was the common organism followed by E. coli. Mortality rate in our study was zero and all the patients became clinically well. From the questionnaire survey, all the doctors and nurses were aware of HAIs and the most common susceptible population according to them were inpatients and the most effective method to prevent HAIs is to wash hand properly, use gloves while doing procedures. Conclusion: VAP was more prominent followed by SSI and CLABSI. Study clearly indicates that educational interventions should be implemented to address the gaps regarding knowledge and practice of nurse and physicians.