Patient Safety

Baid, Heather

doi:10.1016/j.cnc.2016.07.005

Cited by 16 publications

(7 citation statements)

References 40 publications

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“…Starting from the aspects related to our study of the correspondence between infection, section and pathogen, it is recommended the rapid, vigilant and targeted application of HAI prevention and control strategies for reducing infections in intensive care units [30][31][32][33][34][35], of surgical infections in the pre-, intra-and post-operative phase [36][37][38], reduction of urinary catheter infections [39][40][41], reduction of intravascular catheter infections [42,43], respectively, reduction infections with Clostridioides difficile [44].…”

Section: Discussionmentioning

confidence: 99%

Healthcare Associated Infections—A New Pathology in Medical Practice?

Voidăzan

Albu

Tóth³

et al. 2020

IJERPH

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Background: Hospital-acquired infections (HAI) contribute to the emotional stress and functional disorders of the patient and in some cases, can lead to a state of disability that reduces quality of life. Often, HAI are one of the factors that lead to death. The purpose of this study was to analyze the cases of HAI identified in public hospitals at the county level, through case report sheets, as they are reported according to the Romanian legislation. Methods: We performed a cross sectional study design based on the case law of the data reported to the Mures Public Health Directorate, by all the public hospitals belonging to this county. We tracked hospital-acquired infections reported for 2017-2018, respectively, a number of 1024 cases, which implies a prevalence rate of 0.44%, 1024/228,782 cases discharged from these hospitals during the studied period. Results: The most frequent HAIs were reported by the intensive care units (48.4%), the most common infections being the following: bronchopneumonia (25.3%), enterocolitis with Clostridioides difficile (23.3%), sepsis, surgical wound infections and urinary tract infections. At the basis of HAI were 22 pathogens, but the five most common germs were Clostridioides difficile, Acinetobacter baumannii, Klebsiella pneumoniae, Pseudomonas aeruginosa and Staphylococcus aureus. Bronchopneumonia have been most frequently reported in intensive care units, the most common being identified the Acinetobacter baumannii agent. Sepsis and central catheter infections also appeared predominantly in intensive care units, more often with Klebsiella pneumoniae. The enterocolitis with Clostridioides difficile, were the apanage of the medical sections. Infections with Staphylococcus aureus have been identified predominantly in the surgical sections at the level of the surgical wounds. Urinary infections had a similar distribution in the intensive care units, the medical and surgical sections, with Klebsiella pneumoniae being the most commonly incriminated agent. Conclusions: We showed a clear correspondence between the medical units and the type of HAI: what recommends the rapid, vigilant and oriented application of the prevention and control strategies of the HAI. Author Contributions: Data curation, S.V., S.A. and I.M.; Funding acquisition, B.G. and A.R.; Investigation, S.V., Réka Toth and I.M.; Methodology, S.V. and S.A.; Resources, R.T., B.G., A.R. and I.M.; Supervision, S.V., S.A. and I.M.; Visualization, R.T. and B.G.; Writing-original draft, S.V. and A.R.; Writing-review and editing, S.A. and B.G. All authors have read and agreed to the published version of the manuscript. Funding: This research received no external funding. Conflicts of Interest:The authors declare no conflict of interest.

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Section: Discussionmentioning

confidence: 99%

Healthcare Associated Infections—A New Pathology in Medical Practice?

Voidăzan

Albu

Tóth³

et al. 2020

IJERPH

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“…In patients with severe ARF, altered consciousness, unstable vital signs, severe cardiac arrhythmia, or requiring emergency intubation; IPPV is indicated [10]. Although, complications associated with mechanical ventilation and intubation-ventilator associated pneumonia, pulmonary edema, pleural effusion, and atelectasis - cannot be neglected [11]. There is published literature in relation to the efficacy of NIPPV in comparison to standard medical care and also in comparison to IPPV; the impact of NIPPV and IPPV on clinical and biochemical profile of patients with acute respiratory failure secondary to COPD is not readily documented.…”

Section: Introductionmentioning

confidence: 99%

Invasive versus Non-invasive Positive Pressure Ventilation In Chronic Obstructive Pulmonary Disease Complicated By Acute Respiratory Failure

Devi

Raja²,

Kumar

et al. 2019

Cureus

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IntroductionAcute exacerbation of chronic obstructive pulmonary disease (AECOPD) is frequently encountered as a medical emergency. AECOPD is the third leading medical cause of hospitalization due to acute respiratory failure (ARF). The utilization of ventilators for patients with ARF secondary to AECOPD has increased. There has been a major inclination towards utilization of non-invasive positive pressure ventilation (NIPPV) and sparing invasive positive pressure ventilation (IPPV) for life-threatening respiratory distress and/or in patients where NIPPV failure is observed. The aim of this observational study was to compare the clinical and laboratory parameters patients with chronic obstructive pulmonary disease (COPD) complicated by ARF admitted in the intensive care unit (ICU).MethodsIn the prospective observational study with known cases of COPD complicated by ARF, patients were grouped into NIPPV and IPPV groups based on their clinical and laboratory parameters. Thirty patients were included in each group. Demographic data was collected. Clinical and laboratory parameters were evaluated at baseline and at 24 hours of ventilation. The outcome was assessed in terms of duration of ventilation, hospital and ICU stay and overall mortality. Data was entered and analyzed using SPSS version 22.0 (IBM Corp., Armonk, NY).ResultsBoth IPPV and NIPPV groups demonstrated marked reduction in partial pressure of carbon dioxide (PaCO2) with 24 hours of ventilation (for IPPV: 78.1 ± 20.2 vs. 69.1 ± 20.2; p=0.08) (for NIPPV: 68.1 ± 17.8 vs. 57.2 ± 21.5; p=0.03). In NIPPV group, there was significant improvement in partial pressure of oxygen (PaO2) (p=0.009), respiratory rate (p=0.008), heart rate (p<0.0001), systolic blood pressure (p=0.03), and diastolic blood pressure (p<0.0001). These parameters did not improve significantly in the IPPV group except for systolic blood pressure (p=0.008). The NIPPV failure rate was 20%. NIPPV patients had a significantly shorter duration of ventilation, ICU stay, and hospital stay. In-ICU mortality was significantly lower in the NIPPV group as compared to IPPV (13% vs. 40%; p=0.01). There was no difference in post-ICU in-hospital mortality between the two groups (6.7% vs. 16.7%; p=0.13).ConclusionBoth NIPPV and IPPV are effective in normalizing acidosis and hypercapnia in patients with COPD complicated by ARF. Patients managed with non-invasive mode of ventilation have a shorter duration of ICU as well as hospital stay. Survival rates are also better as compared to patients managed with invasive ventilation.

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“…The clinical symptoms of VAP are complex and early diagnosis is difficult. Once VAP occurs, patients suffer difficulties withdrawing from MV, have prolonged hospitalization, increased hospitalization expenses and an increased danger to life 6–8. Of the 901 elderly MV patients observed in this study, 156 met the diagnostic criteria for VAP (incidence=17.3%).…”

Section: Discussionmentioning

confidence: 80%

“…It has been reported that the incidence of VAP is 9–27% with a mortality of 25–50% 4–6. VAP can lead to the deterioration of a patient’s condition, endanger the patient’s life, and increase the health-care burden 6–8. As the average age of the Chinese population is increasing, the number of elderly patients requiring MV is rising.…”

Section: Introductionmentioning

confidence: 99%

<p>Risk factors of ventilator-associated pneumonia in elderly patients receiving mechanical ventilation</p>

Xu¹,

Chunyun²,

Meng³

et al. 2019

CIA

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Purpose: The aim of this study was to verify the potential risk factors of ventilator-associated pneumonia (VAP) in elderly Chinese patients receiving mechanical ventilation (MV). The secondary aim of this study was to present logistical regression prediction models of VAP occurrence in elderly Chinese patients receiving MV. Methods: Patients (aged 80 years or above) receiving MV for ≥48 h were enrolled from the Chinese People’s Liberation Army (PLA) General Hospital from January 2011 to December 2015. A chi-squared test and Mann–Whitney U-test were used to compare the data between participants with VAP and without VAP. Univariate logistic regression models were performed to explore the relationship between risk factors and VAP. Results: A total of 901 patients were included in the study, of which 156 were diagnosed as VAP (17.3%). The incidence density of VAP was 4.25/1,000 ventilator days. Logistic regression analysis showed that the independent risk factors for elderly patients with VAP were COPD (OR =1.526, P 0.05), intensive care unit (ICU) admission (OR=1.947, P 0.01), the MV methods ( P 0.023), the number of antibiotics administered (OR=4.947, P 0.01), the number of central venous catheters (OR=1.809, P 0.05), the duration of indwelling urinary catheter (OR=1.805, P 0.01) and the use of corticosteroids prior to MV (OR=1.618, P 0.05). Logistic regression prediction model of VAP occurrence in the Chinese elderly patients with mechanical ventilation: Conclusion: VAP occurrence is associated with a variety of controllable factors including the MV methods and the number of antibiotics administered. A model was established to predict VAP occurrence so that high-risk patients could be identified as early as possible.

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Patient Safety

Cited by 16 publications

References 40 publications

Healthcare Associated Infections—A New Pathology in Medical Practice?

Healthcare Associated Infections—A New Pathology in Medical Practice?

Invasive versus Non-invasive Positive Pressure Ventilation In Chronic Obstructive Pulmonary Disease Complicated By Acute Respiratory Failure

<p>Risk factors of ventilator-associated pneumonia in elderly patients receiving mechanical ventilation</p>

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