Original scientific paper
The impact of interventions to improve adherence to preventive measures on the incidence of nosocomial infections in ICUs
NIKOLINA MARIĆ
; Department of Emergency and Intensive Care Medicine, Clinical Hospital Sveti Duh, Sveti Duh 64, 10 000 Zagreb, Croatia
NIKOLA UDILJAK
; Department of Emergency and Intensive Care Medicine, Clinical Hospital Sveti Duh, Sveti Duh 64, 10 000 Zagreb, Croatia
NIKOLINA TOLJ KARAULA
; Department of Emergency and Intensive Care Medicine, Clinical Hospital Sveti Duh, Sveti Duh 64, 10 000 Zagreb, Croatia
HELENA JURINA
; Department of Emergency and Intensive Care Medicine, Clinical Hospital Sveti Duh, Sveti Duh 64, 10 000 Zagreb, Croatia
MAJA MAČKOVIĆ
; Department of Emergency and Intensive Care Medicine, Clinical Hospital Sveti Duh, Sveti Duh 64, 10 000 Zagreb, Croatia
DINKO BEKIĆ
; Department of Emergency and Intensive Care Medicine, Clinical Hospital Sveti Duh, Sveti Duh 64, 10 000 Zagreb, Croatia
Abstract
Half of all life-threating nosocomial infections occur in intensive care units (ICUs) and, despite the advances in intensive
care, the incidence of nosocomial infections is still high. About one third of nosocomial infections are considered preventable.
Awareness of risk factors, adherence to preventive measures and collaboration of all members participating in preventive
programmes can lead to reduction of the incidence of nosocomial infections and thus can produce a positive impact on
reducing morbidity, mortality and healthcare costs. A retrospective surveillance study was performed in a 14-bed medical
ICU to identify device-related infections before and after the preventive interventions. Ventilator-associated pneumonia
(VAP), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI)
were obtained and compared before and after the interventions. In the year before the interventions, device-related nosocomial
infections were diagnosed in 7.9% out of 737 hospitalised patients in the ICU, and in the year after the interventions
they were diagnosed in 5.1% out of 684 hospitalised patients. Before the interventions, the infection rates were distributed
as follows: 7.5 CLABSI/1000 catheter days, 28.4 VAP/1000 ventilator days, 6.5 CAUTI/1000 catheterisation days. After the
interventions, the rates were distributed as follows: 2.5 CLABSI/1000 catheter days, 26.5 VAP/1000 ventilator days and 4.1
CAUTI/1000 catheterisation days. The implementation of effective preventive measures and maintaining strict surveillance
is the basis of limiting the risk of nosocomial infections. Since hospital nosocomial infection rate is considered an indicator
of quality and safety of care, all infection control activities are focused to decrease rate of nosocomial infections.
Keywords
nosocomial infections; intensive care unit; prevention and control; invasive procedures
Hrčak ID:
134150
URI
Publication date:
1.6.2014.
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