Impact of an educational program on reducing health care–associated meningitis or ventriculitis in the neurosurgical intensive care unit

Yang, Li; Wang, Rong; Song, Peixin; Ge, Hai; Li, Yi‐Chen; Ji, Cuiling; Jiang, Yihong

doi:10.1016/j.ajic.2019.10.012

Cited by 6 publications

(3 citation statements)

References 25 publications

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“…It is recommended to limit manipulation and avoid fixed interval exchanges of drains or routine sampling of CSF [33]. Education of healthcare professionals on preventive measures could significantly reduce the HCAMV rate [34].…”

Section: Recent Findingsmentioning

confidence: 99%

Healthcare-associated central nervous system infections

Ippolito

Giarratano

Cortegiani

2022

Current Opinion in Anaesthesiology

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Purpose of reviewThe aim of this review is to provide a practical and updated summary on healthcare-associated central nervous system infections and their management. Recent findingsThe term 'healthcare-associated ventriculitis and meningitis' has recently been coined and clinical practical guidelines have been published on the management of these nosocomial infections. Many aspects have still to be further investigated (e.g. cerebrospinal fluid biomarkers, indications for novel antibiotics, intrathecal antimicrobial regimens). SummaryClinicians should maintain a high index of suspicion for healthcare-associated central nervous system infections in patients with specific risk factors (i.e. recent neurosurgery, cerebrospinal shunts, drains or implantable devices, head/spinal traumatic events), taking into account systemic signs, and alterations in microbiological, imaging, cerebrospinal fluid findings. The diagnosis is often difficult to confirm because of reduced levels of consciousness or coma. Both Gram-positive and Gram-negative (often multidrug-resistant or even pandrug-resistant) microorganisms may be the cause. Selection of antibiotics must consider susceptibility and penetration into the central nervous system. Ineffective treatments are frequent, and mortality can reach 60%. Future research should focus on the diagnostic performance of biomarkers and on the use of novel antimicrobial regimens, especially for the treatment of difficult to treat infections.

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Section: Recent Findingsmentioning

confidence: 99%

Healthcare-associated central nervous system infections

Ippolito

Giarratano

Cortegiani

2022

Current Opinion in Anaesthesiology

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“…e PPP should be distinguished from a symptom of postoperative bacterial meningitis. Because healthcare-associated meningitis or ventriculitis is a serious complication in different neurosurgical procedures and is associated with significant morbidity and mortality [16], in the middle of the COVID-19 pandemic, the PPP should also be distinguished from COVID-19 infection [17].…”

Section: Postoperative Prolonged Pyrexia (Ppp)mentioning

confidence: 99%

Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst

Yoneoka

Seki

Akiyama

et al. 2021

Case Reports in Neurological Medicine

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Prolonged postoperative pyrexia (PPP) due to Mollaret’s meningitis following endoscopic transsphenoidal surgery (eTSS) for an intracranial epidermoid cyst can be confused with postoperative meningeal infection after transsphenoidal resection, especially in the middle of the COVID-19 pandemic. Anosmia, as well as dysgeusia, cannot be evaluated in patients of eTSS for a while after surgery. We report a case of an infundibular epidermoid cyst with post-eTSS Mollaret’s meningitis (MM). The post-eTSS MM caused vasopressin-analogue-resistant polyuria (VARP) in synchronization with PPP. A 59-year-old man experiencing recurrent headaches and irregular bitemporal hemianopsia over three months was diagnosed with a suprasellar tumor. The suprasellar tumor was an infundibular cyst from the infundibular recess to the posterior lobe of the pituitary, which was gross-totally resected including the neurohypophysis via an extended eTSS. Since awakening from general anesthesia after the gross total resection (GTR) of the tumor, the patient continuously had suffered from headache until the 13th postoperative day (POD13). The patient took analgesics once a day before the surgery and three times a day after the surgery until POD11. Pyrexia (37.5–39.5 degree Celsius) in synchronization with nonnephrogenic VARP remitted on POD18. Intravenous antibiotics had little effect on changes of pyrexia. Serum procalcitonin values (reference range <0.5 ng/mL) are 0.07 ng/mL on POD12 and 0.06 ng/mL on POD18. His polyuria came to react with sublingual desmopressin after alleviation of pyrexia. He left the hospital under hormone replacement therapy without newly added neurological sequelae other than hypopituitarism. After GTR of an infundibular epidermoid cyst, based on values of serum procalcitonin, post-eTSS MM can be distinguished from infection and can be treated with symptomatic treatments. The postoperative transient nonnephrogenic VARP that differs from usual central diabetes insipidus can react with sublingual desmopressin after alleviation of PPP in the clinical course of post-eTSS MM. An infundibular epidermoid cyst should be sufficiently resected in one sitting to minimize comorbidities, its recurrence, or postoperative MM to the utmost.

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“…Many pieces of literature over decade high lightened the gap in education and trauma management needs, so this gap produces the development, tailored, and construct educational materials, each one objective to a specific aspect of trauma care [3,4,5,6,7] . On the other hand, many researchers tend to fill the knowledge gap among nurses through exploring their needs, develops educational tools, construct programs not only to solve current problems but to keep quality of education inside the hospital and update the information regarding best available evidence [7,8,9,10] . Also, literature discussed the factors that can effects patients outcomes after traumatic brain injury, one of these factors is how the patients managed at injury moment and the definite care did not include only at the scene of injury, may continue at a hospital [11,4] .…”

Section: Introductionmentioning

confidence: 99%

Effectiveness of an Educational Program in Nurses’ Knowledge toward Traumatic Head Injury during Golden Hour at Neurosurgical Hospital

2020

IJFMT

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Background: Globally, traumatic head injury higher mortality rate, and unpredictable outcome. Improvement of nurses' knowledge of how to deal with early periods of the traumatic head can improve patients outcomes.Objectives: This study aims to assess the effectiveness of an educational program in nurses' knowledge toward traumatic head injury during golden hour.Method: A quasi-experimental design was used in this study to assess 50 nurses' knowledge regarding constructed educational programs toward traumatic head injury during golden hour who works in critical care units in Neuro-surgical hospital. The measurement of the effectiveness of educational program through the nurses knowledge includes(54)items concern knowledge related Anatomy of the head and brain; Physiology of intracranial pressure( ICP),cerebral perefusion pressureCPP and blood pressure( BP); Primary and secondery survey; fluid supply; information about traumatic head injury during golden hour . Reliability of instrument was determined through the use of test and retest and the instrument validity was determined through a panel of experts. Results:The study show a comparison significance association between study and control group during pretest and post-test regarding overall assessment, there are improvements in study group knowledge level, the significant association for were P= 0.000. For the control group, there is no significant association between pretest and post-test P= 0.733 p-value >0.005. Conclusion:The study concludes the current educational program effectively and can improve nurses knowledge in critical care units and recommends to further study assess nurses practice regarding traumatic head injury during golden hour, Adopting an educational program for all nurses and more involved in continuous education lectures and workshops.

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Impact of an educational program on reducing health care–associated meningitis or ventriculitis in the neurosurgical intensive care unit

Cited by 6 publications

References 25 publications

Healthcare-associated central nervous system infections

Healthcare-associated central nervous system infections

Prolonged Postoperative Pyrexia and Transient Nonnephrogenic Vasopressin-Analogue-Resistant Polyuria following Endoscopic Transsphenoidal Resection of an Infundibular Epidermoid Cyst

Effectiveness of an Educational Program in Nurses’ Knowledge toward Traumatic Head Injury during Golden Hour at Neurosurgical Hospital

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