National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand: The Role of Safely Culture and Collaboratives

2012 ◽  
Vol 33 (7) ◽  
pp. 711-717 ◽  
Author(s):  
Anucha Apisarnthanarak ◽  
M. Todd Greene ◽  
Edward H. Kennedy ◽  
Thana Khawcharoenporn ◽  
Sarah Krein ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Venous Catheter ◽  
Central Line ◽  
Hospital Characteristic ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infection ◽  
Central Venous ◽  
Healthcare Associated ◽  
Hospital Characteristics

Objective.To evaluate hospital characteristics and practices used by Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP), the 3 most common types of healthcare-associated infection (HAI) in Thailand.Design.Survey.Setting.Thai hospitals with an intensive care unit and 250 or more hospital bedsMethods.Between January 1, 2010, and October 31, 2010, research nurses collected data from all eligible hospitals. The survey assessed hospital characteristics and practices to prevent CAUTI, CLABSI, and VAP. Ordinal logistic regression was used to assess relationships between hospital characteristics and use of prevention practices.Results.A total of 204 (80%) of 256 hospitals responded. Most hospitals (93%) reported regularly using alcohol-based hand rub. The most frequently reported prevention practice by infection was as follows: for CAUTI, condom catheters in men (47%); for CLABSI, avoiding routine central venous catheter changes (85%); and for VAP, semirecumbent positioning (84%). Hospitals with peripherally inserted central catheter insertion teams were more likely to regularly use elements of the CLABSI prevention bundle. Greater safety scores were associated with regular use of several VAP prevention practices. The only hospital characteristic associated with increased use of at least 1 prevention practice for each infection was membership in an HAI collaborative.Conclusions.While reported adherence to hand hygiene was high, many of the prevention practices for CAUTI, CLABSI, and VAP were used infrequently in Thailand. Policies and interventions emphasizing specific infection prevention practices, establishing a strong institutional safety culture, and participating in collaboratives to prevent HAI may be beneficial.

The Past, Present, and Future of Healthcare-Associated Infection Prevention in Pediatrics: Catheter-Associated Bloodstream Infections

2010 ◽  
Vol 31 (S1) ◽  
pp. S27-S31 ◽  
Author(s):  
Kristina A. Bryant ◽  
Danielle M. Zerr ◽  
W. Charles Huskins ◽  
Aaron M. Milstone
Keyword(s):  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Morbidity And Mortality ◽  
Prevention Strategies ◽  
Healthcare Associated Infection ◽  
Research Topics ◽  
The Past ◽  
Healthcare Associated ◽  
Current Practices

Central line–associated bloodstream infections cause morbidity and mortality in children. We explore the evidence for prevention of central line–associated bloodstream infections in children, assess current practices, and propose research topics to improve prevention strategies.

scholarly journals A Multicenter Longitudinal Study of Hospital-Onset Bacteremia: Time for a New Quality Outcome Measure?

2015 ◽  
Vol 37 (2) ◽  
pp. 143-148 ◽  
Author(s):  
Clare Rock ◽  
Kerri A. Thom ◽  
Anthony D. Harris ◽  
Shanahan Li ◽  
Daniel Morgan ◽  
...  
Keyword(s):  
Infection Prevention ◽  
Outcome Measure ◽  
The United States ◽  
Central Line ◽  
Healthcare Associated Infection ◽  
Interrater Variability ◽  
Important Quality ◽  
Healthcare Associated ◽  
Quality Assessments ◽  
Clabsi Rate

BACKGROUNDCentral-line–associated bloodstream infection (CLABSI) rate is an important quality measure, but it suffers from subjectivity and interrater variability, and decreasing national CLABSI rates may compromise its power to discriminate between hospitals. This study evaluates hospital-onset bacteremia (HOB, ie, any positive blood culture obtained 48 hours post admission) as a healthcare-associated infection–related outcome measure by assessing the association between HOB and CLABSI rates and comparing the power of each to discriminate quality among intensive care units (ICUs).METHODSIn this multicenter study, ICUs provided monthly CLABSI and HOB rates for 2012 and 2013. A Poisson regression model was used to assess the association between these 2 rates. We compared the power of each measure to discriminate between ICUs using standardized infection ratios (SIRs) with 95% confidence intervals (CIs). A measure was defined as having greater power to discriminate if more of the SIRs (with surrounding CIs) were different from 1.RESULTSIn 80 ICUs from 16 hospitals in the United States and Canada, a total of 663 CLABSIs, 475,420 central line days, 11,280 HOBs, and 966,757 patient days were reported. An absolute change in HOB of 1 per 1,000 patient days was associated with a 2.5% change in CLABSI rate (P<.001). Among the 80 ICUs, 20 (25%) had a CLABSI SIR and 60 (75%) had an HOB SIR that was different from 1 (P<.001).CONCLUSIONChange in HOB rate is strongly associated with change in CLABSI rate and has greater power to discriminate between ICU performances. Consideration should be given to using HOB to replace CLABSI as an outcome measure in infection prevention quality assessments.Infect. Control Hosp. Epidemiol. 2016;37(2):143–148

Central-Line–Associated Bloodstream Infections in Québec Intensive Care Units: Results from the Provincial Healthcare-Associated Infections Surveillance Program (SPIN)

2016 ◽  
Vol 37 (10) ◽  
pp. 1186-1194 ◽  
Author(s):  
Lynne Li ◽  
Elise Fortin ◽  
Claude Tremblay ◽  
Muleka Ngenda-Muadi ◽  
Caroline Quach ◽  
...  
Keyword(s):  
Intensive Care ◽  
Central Venous Catheter ◽  
Intensive Care Units ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Line ◽  
Incidence Rates ◽  
Surveillance Program ◽  
Central Venous ◽  
Healthcare Associated

BACKGROUNDFollowing implementation of bundled practices in 2009 in Quebec and Canadian intensive care units (ICUs), we describe CLABSI epidemiology during the last 8 years in the province of Québec (Canada) and compare rates with Canadian and American benchmarks.METHODSCLABSI incidence rates (IRs) and central venous catheter utilization ratios (CVCURs) by year and ICU type were calculated using 2007–2014 data from the Surveillance Provinciale des Infections Nosocomiales (SPIN) program. Using American and Canadian surveillance data, we compared SPIN IRs to rates in other jurisdictions using standardized incidence ratios (SIRs).RESULTSIn total, 1,355 lab-confirmed CLABSIs over 911,205 central venous catheter days (CVC days) were recorded. The overall pooled incidence rate (IR) was 1.49 cases per 1,000 CVC days. IRs for adult teaching ICUs, nonteaching ICUs, neonatal ICUs (NICUs), and pediatric ICUs (PICUs) were 1.04, 0.91, 4.20, and 2.15 cases per 1,000 CVC days, respectively. Using fixed SPIN 2007–2009 benchmarks, CLABSI rates had decreased significantly in all ICUs except for PICUs by 2014. Rates declined by 55% in adult teaching ICUs, 52% in adult nonteaching ICUs, and 38% in NICUs. Using dynamic American and Canadian CLABSI rates as benchmarks, SPIN adult teaching ICU rates were significantly lower and adult nonteaching ICUs had lower or comparable rates, whereas NICU and PICU rates were higher.CONCLUSIONQuébec ICU CLABSI surveillance shows declining CLABSI rates in adult ICUs. The absence of a decrease in CLABSI rate in NICUs and PICUs highlights the need for continued surveillance and analysis of factors contributing to higher rates in these populations.Infect Control Hosp Epidemiol 2016;1–9

scholarly journals IMPACT OF SELF-INSTRUCTIONAL MODULE ON PERCEPTION REGARDING CATHETER RELATED BLOOD STREAM INFECTIONS AMONG NURSING OFFICERS IN SELECTED HOSPITALS OF MADHYA PRADESH

2021 ◽  
pp. 1-2
Author(s):  
Asha Dubey ◽  
Rajni Thakur
Keyword(s):  
Bloodstream Infections ◽  
Venous Catheter ◽  
Blood Stream ◽  
Central Line ◽  
Control Group ◽  
Central Venous ◽  
Instructional Module ◽  
Intravascular Catheters ◽  
Healthcare Associated ◽  
Experimental Group

Infections associated with intravascular catheters account for 10% to 20% of all nosocomial infections. Healthcare-associated infections are a significant problem and 20-40 percent of healthcare-associated bloodstream infections may be linked to a central venous catheter. This infection is referred to as central line associated bacteremia. At posttest stage, the average (Mean ± Standard Deviation) perception scoring (38.04±5.75 points) among nursing officers of experimental group found to be significantly higher and improved after administration of self-instructional module as compared to average perception scoring (29.47±6.23 points) of nursing officers of control group who received placebo.

scholarly journals Healthcare-Associated Infections Among Neonates in Brazil

2004 ◽  
Vol 25 (9) ◽  
pp. 772-777 ◽  
Author(s):  
Carmem Lúcia Pessoa-Silva ◽  
Rosana Richtmann ◽  
Roseli Calil ◽  
Rosana Maria Rangel Santos ◽  
Maria Luiza M. Costa ◽  
...  
Keyword(s):  
Perinatal Care ◽  
Venous Catheter ◽  
Incidence Density ◽  
Ventilator Associated Pneumonia ◽  
Healthcare Associated Infections ◽  
Maternal Origin ◽  
Central Venous ◽  
Prospective Surveillance ◽  
Coagulase Negative Staphylococci ◽  
Healthcare Associated

AbstractObjective:To describe the epidemiology of healthcare-associated infections (HAIs) among neonates.Design:Prospective surveillance of HAIs was conducted during 2 years. Infections beginning within 48 hours of birth were defined as HAIs of maternal origin. Death occurring during an active episode of HAI was considered related to HAI.Setting:Seven neonatal units located in three Brazilian cities.Patients:All admitted neonates were included and observed until discharge.Results:Twenty-two percent of 4,878 neonates had at least one HAI. The overall incidence density was 24.9 per 1,000 patient-days, and 28.1% of all HAIs were maternally acquired. HAI rates ranged from 12.3% in the group with a birth weight (BW) of more than 2,500 g to 51.9% in the group with a BW of 1,000 g or less. The main HAIs were bloodstream infection (BSI) and pneumonia. Coagulase-negative staphylococci, Enterobacter species, Staphylococcus aureus, and Klebsiella pneumoniae were the main pathogens. Forty percent of all deaths were related to HAI. Central venous catheter (CVC)-associated BSIs per 1,000 CVC-days ranged from 17.3 (BW, 1,501 to 2,500 g; device utilization [DU], 0.11) to 34.9 (BW, ≤ 1,000 g; DU, 34.92). Ventilator-associated pneumonia per 1,000 ventilator-days ranged from 7.0 (BW, ≤ 1,000 g; DU, 0.34) to 9.2 (BW, 1,001 to 1,500 g; DU, 0.14).Conclusions:The high proportion of HAIs of maternal origin highlights perinatal care issues in Brazil and the need to improve the diagnosis of neonatal HAIs. The very low BW group and device-associated infections should be priorities for prevention strategies in this population.

A systematic review and meta-analysis of risk factors associated with acquisition of waterborne healthcare-associated infection or colonization in high-risk units

2019 ◽  
pp. 1-4
Author(s):  
Lina M. Parra ◽  
Mireia Cantero ◽  
Juliana Sierra ◽  
Ángel Asensio ◽  
Fernando J. García
Keyword(s):  
Meta Analysis ◽  
Adult Population ◽  
Venous Catheter ◽  
Healthcare Associated Infections ◽  
Healthcare Associated Infection ◽  
Central Venous ◽  
Factors Associated ◽  
Standardized Mean Difference ◽  
Healthcare Associated

Abstract In this meta-analysis, central venous catheter exposure (pooled odds ratio, 8.02; 95% confidence interval [CI], 2.19–29.31; P < .01) in neonates and length of stay (standardized mean difference, 0.65; 95% CI, 0.26–1.05; P = .01) in an adult population were associated with acquisition of waterborne healthcare-associated infections or colonization in ICUs. The quality of evidence was low.

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