Device-associated infection rates and extra length of stay in an intensive care unit of a university hospital in Wroclaw, Poland: International Nosocomial Infection Control Consortium's (INICC) findings

Kübler, Andrzej; Duszyńska, Wiesława; Rosenthal, Víctor D.; Fleischer, Małgorzata; Kaiser, Teresa; Szewczyk, Ewa; Barteczko-Grajek, Barbara

doi:10.1016/j.jcrc.2011.05.018

Cited by 44 publications

(59 citation statements)

References 35 publications

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“…The rate of VAP was decreased by 7.97/1000 ventilator days compared to that in our centre in the years 2007−2010 [22] and decreased by 6.27/1000 ventilation days compared to developing countries [18], while it was still higher than the 1.1 (1.0−1.2) in the American NHSN report of 2012 [17]. The most common aetiological factors of VAP, without considering the division in early and late VAP, include Acinetobacter baumannii, Pseudomonas aeruginosa, and Klebsiella pneumoniae [17].…”

Section: Discussioncontrasting

confidence: 50%

“…Multiple monitoring of DA-HAIs, performed by the same team within the INICC project, indicates that infection surveillance and institution of preventive procedures can result in infection reduction. With respect to VAP, its incidence decreased by 38% compared to the first published results of surveillance according to the INICC [22]. Although infection surveillance over many years showed a decreasing tendency in VAP density, the study over the 2.5 year periods did not reveal further decreases in the ventilator-associated pneumonia incidence.…”

Section: Discussionmentioning

confidence: 60%

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Monitorowanie zapalenia płuc związanego z wentylacją mechaniczną według projektu INICC — doświadczenia jednego ośrodka

Duszyńska¹,

Rosenthal²,

Dragan³

et al. 2015

Anaesthesiol Intensive Ther

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Background: Pneumonia is a common complication of hospitalisation in severely ill patients who need mechanical ventilation. The aim of this study was to assess the usefulness of the International Nosocomial Infection Control Consortium programme for the surveillance of ventilator-associated pneumonia (VAP). Methods: A prospective study (1 Jan 2012−30 June 2014) was conducted in the 20-bed ICU. The device utilisation ratios for lung ventilation and the frequency (density and incidence) and aetiology of VAP were estimated in ICU patients. Results: From a total of 1097 patients, VAP infections were diagnosed in 93. Thirty percent of patients with VAP died. The incidence index was 8.47 per 100 admissions to the ICU. VAP infections accounted for 46% of the overall count of device-associated healthcare-associated infections. Mechanical ventilation was used in 71 ± 8 patients during the 11 862 patient days and 8425 ventilation days. The rate of VAP per 1000 ventilator days was 11.15/9.34/10.23 in years 2012/2013/2014 (half a year), respectively. The main VAP pathogens were Acinetobacter baumannii (45%) and Pseudomonas aeruginosa (17%). Conclusion: During the reported time span, the incidence of VAP was lower than in the INICC report (2007−2012), but it was tenfold higher than in the NHSN/CDC report (dated 2012). Because of the unchanged VAP level during the 2.5-year observation period, the root cause needs to be determined and action should be taken to resolve this issue.

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Section: Discussioncontrasting

confidence: 50%

Section: Discussionmentioning

confidence: 60%

Monitorowanie zapalenia płuc związanego z wentylacją mechaniczną według projektu INICC — doświadczenia jednego ośrodka

Duszyńska¹,

Rosenthal²,

Dragan³

et al. 2015

Anaesthesiol Intensive Ther

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“…A ocorrência de infecções relacionadas à assistência à saúdeem pacientes internados em unidade de terapia intensiva contribui para o aumento no tempo de internação, maior mortalidade e aumento de gastos com medicamentos e materiais (9)(10)(11) . Essas complicações infecciosas podem representar ônus ao paciente, expresso no aumento da carga de doença e no estabelecimento de quadro séptico associado (12) .…”

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Fatores De Risco Às Infecções Relacionadas À Assistência Em Unidades De Terapia Intensiva*

et al. 2018

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RESUMO: Objetivo: identificar os pacientes e os fatores de risco associados à ocorrência de infecções relacionadas à assistência à saúde em unidades de terapia intensiva. Método: estudo transversal realizado com 155 pacientes internados entre 2012 e 2014 em duas unidades de terapia intensiva de dois hospitais públicos do Distrito Federal. Os dados foram coletados em prontuário e registrados em planilha no programa Microsoft Excel®. Foram considerados significativos resultados com p-value<0,05. Resultados: do total de 155 pacientes, 55 (35,5%) pacientes foram acometidos por infecções relacionadas à assistência à saúde durante a internação na unidade de terapia intensiva. Tempo de internação (p=0,001), internação por causas clínicas (p=0,017), diabetes mellitus (p=0,002) e cirurgia eletiva (p=0,011), foram fatores de risco, independentes para essas infecções. Conclusão: as complicações infecciosas acometeram cerca de um terço dos pacientes no cenário de terapia intensiva. A vigilância dessas complicações pode orientar ações para melhoria da segurança do paciente crítico. DESCRITORES: Infecção hospitalar; Unidades de terapia intensiva; Fatores de risco; Hospitais públicos; Pacientes. RISK FACTORS FOR HEALTHCARE-ASSOCIATED INFECTIONS IN INTENSIVE CARE UNITSABSTRACT: Objective: to identify patients and risk factors related to the occurrence of healthcare-associated infections in intensive care units. Method: cross-sectional study with 155 hospitalized patients between 2012 and 2014 in two intensive care units of two public hospitals of the Federal District. Data were collected from the medical records and recorded in a spreadsheet using the Microsoft Excel® program. Results with p-value <0.05 were considered significant. Results: of the total of 155 patients, 55 (35.5%) patients were affected by healthcare-associated infections during hospitalization in the intensive care unit. Length of stay (p=0.001), hospitalization due to clinical causes (p=0.017), diabetes mellitus (p=0.002) and elective surgery (p=0.011) were independent risk factors for these infections. Conclusion: infectious complications affected approximately one third of the patients in the intensive care setting. Surveillance of these complications may guide actions to improve the safety of critical patients. KEYWORDS: Cross Infection; Intensive care units; Risk factors; Hospitals, public; Patients. FACTORES DE RIESGO A INFECCIONES ASOCIADAS A LA ASISTENCIA EN UNIDADES DE TERAPIA INTENSIVA*RESUMEN: Objetivo: identificar los pacientes y los factores de riesgo asociados a la ocurrencia de infecciones relacionadas a la asistencia a la salud en unidades de terapia intensiva. Método: estudio transversal realizado con 155 pacientes internados entre 2012 y 2014 en dos unidades de terapia intensiva de dos hospitales públicos de Distrito Federal. Se recogieron los datos por medio de prontuario y se los registraron en programa Microsoft Excel®. Se consideraron significativos resultados con p-value<0,05. Resultados: del total de 155 pacientes, 55 (35,5%) pacientes ...

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“…46 The engagement of nursing champions to implement and sustain CVC care bundles is essential. Nursing champions that recognize the importance of care bundles and the evidence that provides the framework for the bundle elements facilitates buy-in from other nursing staff.…”

Section: Strategies To Increase Compliance With Bundle Elementsmentioning

confidence: 99%

Pediatric central venous access devices: nursing interventions

Duffy¹,

Nelson²

2017

NRR

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A central venous catheter (CVC) is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study Case studyRyker is a previously healthy 9-year old boy. He was brought to the emergency department by ambulance after being hit by a car while riding his bicycle. His injuries included fractures of the pelvis and femur, a pulmonary laceration, and a laceration of spleen. He required multiple surgeries to manage his injuries. During his second surgery, a right subclavian central venous catheter (CVC) was placed. This catheter provides stable venous access for administration of fluids, medications, and labs during his recovery. On hospital day #10, Ryker developed a fever, and labs and blood cultures were drawn. His labs were significant for a white blood cell count of 22,000 cells/mm 3 . The initial gram stain of his blood revealed gram-positive cocci in clusters with a culture positive for coagulase-negative staphylococcus. Ryker was started on antibiotics and his CVC was removed. He continued to recover from his injuries, and he responded well to treatment with antibiotics for his bloodstream infection. He was discharged to an inpatient rehabilitation program on hospital day #18.After further review, and ruling out other potential sources of infection such as a urinary tract infection, surgical site infections, and pulmonary infections, Ryker's positive bloodstream infection was classified as a central line associated-bloodstream infection (CLABSI) using the Center for Disease Control and Prevention (CDC) criteria. This health care-associated infection (HAI) triggered a review by the health care team. Physicians, nurses, respiratory therapists, pharmacists, and other interdisciplinary staff Correspondence: elizabeth A Duffy

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Device-associated infection rates and extra length of stay in an intensive care unit of a university hospital in Wroclaw, Poland: International Nosocomial Infection Control Consortium's (INICC) findings

Cited by 44 publications

References 35 publications

Monitorowanie zapalenia płuc związanego z wentylacją mechaniczną według projektu INICC — doświadczenia jednego ośrodka

Monitorowanie zapalenia płuc związanego z wentylacją mechaniczną według projektu INICC — doświadczenia jednego ośrodka

Fatores De Risco Às Infecções Relacionadas À Assistência Em Unidades De Terapia Intensiva*

Pediatric central venous access devices: nursing interventions

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