Health Care-Associated Infections in a Neurocritical Care Unit of a Developing Country

Abulhasan, Yasser B.; Abdullah, Aneesa; Shetty, Shama A.; Ramadan, Moustapha Ahmed; Yousef, Waleed; Mokaddas, Eiman

doi:10.1007/s12028-019-00856-8

Cited by 16 publications

(14 citation statements)

References 32 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Já a craniotomia a infecção ocorre entre 5 a 8% e cirurgias na coluna espinhal 6% 13 . A taxa de incidência para IRAS em pacientes submetidos a neurocirurgias em Rondônia foi 19,4/100 pacientes (IC95%: 8,19 -36,02), valor superior ao encontrado em um estudo de coorte retrospectivo de três anos, conduzido em um hospital universitário de um país Árabe, com 913 pacientes em tratamento neurológicos onde encontrou uma taxa de incidência geral de IRAS de 11,9/100 pacientes, entre os quais 29% tiveram múltiplas infecções 14 . Outro estudo realizado na China, no período de maio de 2007 a abril de 2012, que incluiu pacientes submetidos às cirurgias cranianas identificou pneumonia no período pós-operatório em 0,5% a 4,1% dos pacientes 15 .…”

Section: Discussionunclassified

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil

Araújo

Pereira²,

Deus³

et al. 2022

Rev Cuid

View full text Add to dashboard Cite

Introducción: Los pacientes neuroquirúrgicos tienen un alto riesgo de complicaciones locales y sistémicas que pueden aumentar la estancia hospitalaria y el riesgo de muerte. Este estudio tiene como objetivo evaluar la incidencia de infecciones asociadas a la atención médica y los factores de riesgo asociados en pacientes sometidos a neurocirugía. Materiales y Métodos: Estudio de cohorte prospectivo, realizado en un gran hospital del estado de Rondônia, de 2018 a 2019, con 36 pacientes. Resultados: La incidencia de infecciones asociadas a la asistencia sanitaria fue de 19,4 por 100 pacientes (IC95%: 8,19 – 36,02). Haber utilizado una sonda nasoenteral aumentó el riesgo de IRAS en 6,5 veces (IC 95%: 1,26 – 33,5), la ventilación mecánica aumentó el riesgo en 5,52 veces (IC 95%: 1,23 – 24,6), la presencia de traqueotomía aumentó seis veces (IC95%: 1,34 – 26,8) y realizar un examen invasivo aumentó el riesgo de infección en 6,79 (IC95%: 1,31 – 35,05). En el análisis ajustado, las variables no presentaron significación estadística. Discusión: La incidencia de infecciones fue mayor que en las regiones con mejores condiciones socioeconómicas, lo que puede estar relacionado con una menor adherencia a las buenas prácticas de cuidado. Conclusión: En neurocirugía, además de las infecciones del sitio quirúrgico, también se deben considerar otras topografías para la investigación de la infección. El uso de dispositivos invasivos se asoció con la ocurrencia de infecciones relacionadas con el cuidado de la salud, por lo que las buenas prácticas en su uso son fundamentales a la hora de indicar y utilizar estos dispositivos. Como citar este artículo: Araújo, Laís Xavier de; Pereira, Priscilla Perez da Silva; Deus, Josimeire Cantanhêde de; Pontes, Daniela Oliveira; Hang, Adriana Tavares; Freitas, Jeanne Lúcia Gadelha; da Silva, Valéria Moreira; Paiva, Karla de Paula; de Souza, Caren Juliana Moura; Meireles, Carla Vanessa Suaris; Rodrigues, Mariana Delfino; Tavares, Daniella Thamara da Silva; Rosa, Marcela Miranda Sanches. Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil. Revista Cuidarte. 2022;13(2): e2154. http://dx.doi.org/10.15649/cuidarte.2154

show abstract

Section: Discussionunclassified

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil

Araújo

Pereira²,

Deus³

et al. 2022

Rev Cuid

View full text Add to dashboard Cite

show abstract

“…Other ICU-based studies have reported an overall infection rate ranging from 11.9% to 48%. 41–45 UTIs and pneumonia are among the most common sites of infection, with varying rates of 4.3%–8.7% and 11.7%–15%, respectively. 41 42 After the implementation period, we could bring the overall infection rate down to 12.83%, mainly driven by a significant reduction of UTIs to 1.57%, as the incidence of pneumonia and other infections remained unchanged.…”

Section: Discussionmentioning

confidence: 99%

Implementation of systematic safety checklists in a neurocritical care unit: a quality improvement study

Escamilla-Ocañas

Torrealba‐Acosta²,

Qasim³

et al. 2022

BMJ Open Qual

View full text Add to dashboard Cite

Background and objectivesStructured and systematised checklists have been shown to prevent complications and improve patient care. We evaluated the implementation of systematic safety checklists in our neurocritical care unit (NCCU) and assessed its effect on patient outcomes.Design/methodsThis quality improvement project followed a Plan–Do–Study–Act (PDSA) methodology. A checklist for medication reconciliation, thromboembolic prophylaxis, glycaemic control, daily spontaneous awakening, breathing trial, diet, catheter/lines duration monitoring and antibiotics de-escalation was implemented during daily patient rounds. Main outcomes included the rate of new infections, mortality and NCCU-length of stay (LOS). Intervened patients were compared with historical controls after propensity score and Euclidean distance matching to balance baseline covariates.ResultsAfter several PDSA iterations, we applied checklists to 411 patients; the overall average age was 61.34 (17.39). The main reason for admission included tumour resection (31.39%), ischaemic stroke (26.76%) and intracerebral haemorrhage (10.95%); the mean Sequential Organ Failure Assessment (SOFA) score was 2.58 (2.68). At the end of the study, the checklist compliance rate throughout the full NCCU stays reached 97.11%. After controlling for SOFA score, age, sex and primary admitting diagnosis, the implementation of systematic checklists significantly correlated with a reduced LOS (ß=−0.15, 95% CI −0.24 to −0.06), reduced rate of any new infections (OR 0.59, 95% CI 0.40 to 0.87) and reduced urinary tract infections (UTIs) (OR 0.23, 95% CI 0.09 to 0.55). Propensity score and Euclidean distance matching yielded 382 and 338 pairs with excellent covariate balance. After matching, outcomes remained significant.DiscussionThe implementation of safety checklists in the NCCU proved feasible, easy to incorporate into the NCCU workflow, and a helpful tool to improve adherence to practice guidelines and quality of care measurements. Furthermore, our intervention resulted in a reduced NCCU-LOS, rate of new infections and rate of UTIs compared with propensity score and Euclidean distance matched historical controls.

show abstract

“…Notably, a very dramatic increase in CAUTI rate might be seen when DUR exceeds .85 compared to DUR <.5. 10,[12][13][14] Judicious urinary catheter use is the most important strategy to control the CAUTI rate. 7 According to findings from epidemiologic studies, the rate of CAUTI and DUR in neuro ICU cases has decreased during the past decade (Table 1).…”

Section: Cauti Epidemiologymentioning

confidence: 99%

“…Lack of organized infection control guidelines, low nurse-to-patient ratios, overcrowded public hospitals, lack of medical supplies or outdated technology, and an insufficient number of trained healthcare workers are among the most important reasons for higher rates of CAUTIs in these countries. 12,13…”

Section: Cauti Epidemiologymentioning

confidence: 99%

Catheter-Associated Urinary Tract Infection in Neurological Intensive Care Units: A Narrative Review

Firoozeh

Agah

Bauer

et al. 2022

The Neurohospitalist

View full text Add to dashboard Cite

Catheter-associated urinary tract infection (CAUTI) is among the most common types of healthcare-associated infection (HAI), which is associated with poor outcomes and prolonged hospitalization in critically ill patients. Previous studies have mentioned that patients admitted to neurological ICUs are at higher risk of CAUTI compared to patients in other ICU settings. This review paper aims to review studies published during the last decade that evaluated the incidence, risk factors, causative pathogens, and preventive strategies and treatment in neuro-critically ill patients.

show abstract

Health Care-Associated Infections in a Neurocritical Care Unit of a Developing Country

Cited by 16 publications

References 32 publications

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil

Fatores de risco nas neurocirurgias: um estudo de coorte no norte do Brasil

Implementation of systematic safety checklists in a neurocritical care unit: a quality improvement study

Catheter-Associated Urinary Tract Infection in Neurological Intensive Care Units: A Narrative Review

Contact Info

Product

Resources

About