Mortality and risks related to healthcare-associated infection

Souza, Ester Sena; Belei, Renata Aparecida; Carrilho, Cláudia Maria Dantas de Maio; Matsuo, Tiemi; Yamada‐Ogatta, Sueli Fumie; Andrade, Galdino; Perugini, Marcia Regina Eches; Pieri, Flávia Meneguetti; Dessunti, Elma Mathias; Kerbauy, Gilselena

doi:10.1590/0104-07072015002940013

Cited by 45 publications

(43 citation statements)

References 23 publications

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“…In a study conducted at the same institution that the present work, 46.5% of patients with infections related to health care have evolved with sepsis, increasing the risk of death by approximately six-fold (p <0.001, RR 5.87), compared with patients who did not develop sepsis. The same study revealed septic shock was the most prevalent complication of sepsis (75%), with a mortality rate reaching 81.3% of patients (19) . Another negative scenario presented in a study showed that over half of the total value of sepsis treatment (R$ 2,215,773.50; US$ 989,626.00) was assigned to patients who progressed to death.…”

Section: Discussionmentioning

confidence: 75%

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Barreto

Dellaroza

Kerbauy

et al. 2016

Rev. esc. enferm. USP

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Objective: To estimate the cost of hospitalization of patients with severe sepsis or septic shock admitted or diagnosed in the Urgent and Emergency sector at a university hospital and followed until the clinical outcome. Method: An epidemiological, prospective, observational study conducted in a public hospital in southern Brazil for the period of one year (August 2013 to August 2014). Sepsis notification forms, medical records and data of the cost sector were used for the collection of clinical and epidemiological data. Results: The sample comprised 95 patients, resulting in a total high cost of hospitalization (R$ 3,692,421.00), and an average of R$ 38,867.60 per patient. Over half of the total value of the treatment of sepsis (R$ 2,215,773.50) was assigned to patients who progressed to death (59.0%). The higher costs were related to discharge, diagnosis of severe sepsis, the pulmonary focus of infection and the age group of up to 59 years. Conclusion: The high cost of the treatment of sepsis justifies investments in training actions and institution of protocols that can direct preventive actions, and optimize diagnosis and treatment in infected and septic patients. Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization Sepse em um hospital universitário: estudo prospectivo para análise de custo da hospitalização de pacientes Sepsis en un hospital universitario: estudio prospectivo para análisis de costo de la hospitalización de pacientes

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Section: Discussionmentioning

confidence: 75%

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Barreto

Dellaroza

Kerbauy

et al. 2016

Rev. esc. enferm. USP

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“…Such an interest may be justified by the fact that HAI are factors associated with extending length of hospital stay, generating high levels of health complications and increasing care costs, as well as favoring the selection and spread of multiresistant organisms (40) , making this event one of the focuses of interest of the PNSP. In this respect, the practice of hand hygiene, created with the aim of preventing and controlling HAI, defined the five major moments in which the hands must be sanitized as well as the technique itself (41) .…”

Section: Discussionmentioning

confidence: 99%

Nursing workload and occurrence of adverse events in intensive care: a systematic review

Oliveira

Garcia

Nogueira

2016

Rev. esc. enferm. USP

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Objective:To identify evidences of the influence of nursing workload on the occurrence of adverse events (AE) in adult patients admitted to the intensive care unit (ICU). Method: A systematic literature review was conducted in the databases MEDLINE, CINAHL, LILACS, SciELO, BDENF, and Cochrane from studies in English, Portuguese, or Spanish, published by 2015. The analyzed AE were infection, pressure ulcer (PU), patient falls, and medication errors. Results: Of 594 potential studies, eight comprised the final sample of the review. The Nursing Activities Score (NAS; 37.5%) and the Therapeutic Intervention Scoring System (TISS; 37.5%) were the instruments most frequently used for assessing nursing workload. Six studies (75.0%) identified the influence of work overload in events of infection, PU, and medication errors. An investigation found that the NAS was a protective factor for PU. Conclusion: The nursing workload required by patients in the ICU influenced the occurrence of AE, and nurses must monitor this variable daily to ensure proper sizing of staff and safety of care.

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“…corroborado por un estudio realizado en una UCI de Paraná, donde el resultado alta fue de 61,6%(23) . Otros estudios internacionales traen resultados donde el porcentaje de alta fue de 83,2%, 89% y 87,2% respectivamente(11,24,25) .…”

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Infección relacionada con la Asistencia a la Salud en Unidad de Cuidados Intensivos Adulto

Hespanhol

Ramos

Junior

et al. 2018

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O presente estudo tem como objetivo caracterizar os casos de infecções relacionadas à assistência à saúde ocorridas em uma UTI adulto. Estudo do tipo descritivo, exploratório, documental e com abordagem quantitativa. A amostra foi constituída por prontuários e fichas de controle de infecção hospitalar da CCIH de todos os casos de infecções ocorridas na UTI do Hospital Universitário Getúlio Vargas em Manaus – Amazonas no período de janeiro de 2013 a dezembro de 2014. Foram selecionados 75 pacientes, sendo a maioria pertencentes ao sexo feminino (60%), com predomínio de idosos (36,5%). Foram classificados como cirúrgicos (45,3%) e tiveram permanência na UTI de 16 ou mais dias (42,7%). Quanto ao perfil das infecções, houve predomínio das relacionadas ao trato respiratório (46,2%) e corrente sanguínea (26,6%), chamando atenção para a Pneumonia Associada à Ventilação Mecânica (35,2%). O estudo mostrou ainda que há predomínio do diagnóstico clínico, laboratorial e de imagem na identificação das IRAS, somando (62,4%), negligenciando a realização de culturas (37,5%). Dentre os microorganismos identificados existe o predomínio dos gram-negativos (28,1%). A maior ocorrência de infecção por dispositivos invasivos ocorreu no uso do tubo orotraqueal (48%). Houve correlação forte e significativa entre o desfecho óbito e a quantidade de infecções presentes (p=0,02) e quanto ao número de patógenos isolados em cada paciente (p=0,03). Torna-se imprescindível a correta investigação dos casos de IRAS, tendo em vista os diferentes fatores associados a sua ocorrência, ficando evidente a necessidade de maior vigilância epidemiológica das infecções em Unidade de Terapia Intensiva. El presente estudio tiene como objetivo caracterizar los casos de infecciones relacionadas a la asistencia a la salud ocurridas en una UCI adulto. Estudio del tipo descriptivo, exploratorio, documental y con abordaje cuantitativo. La muestra fue constituida por archivos y fichas de control de infección hospitalaria de la CCIH de todos los casos de infecciones ocurridas en la UCI del Hospital Universitario Getúlio Vargas en Manaus – Amazonas en el periodo de enero del 2013 a diciembre del 2014. Fueron seleccionados 75 pacientes, siendo la mayoría pertenecientes al sexo femenino (60%), con predominio de ancianos (36,5%). Fueron clasificados como quirúrgicos (45,3%) y tuvieron permanencia en la UCI de 16 o más días (42,7%). En cuanto al perfil de las infecciones, hubo predominio de las relacionadas al tracto respiratorio (46,2%) y corriente sanguínea (26,6%), llamando atención para la Neumonía Asociada a la Ventilación Mecánica (35,2%). El estudio mostró que hay predominio del diagnóstico clínico, de laboratorio y de imagen en la identificación de las IRAS, sumando (62,4%), descuidando la realización de cultivos (37,5%). Entre los microorganismos identificados existe el predominio de los gram negativos (28,1%). La mayor ocurrencia de infección por dispositivos invasivos ocurrió en el uso del tubo orotraqueal (48%). Hubo correlación fuerte y significativa entre el resultado muerto y la cantidad de infecciones presentes (p=0,02) y cuanto al número de patógenos aislados en cada paciente (p=0,03). Se vuelve imprescindible la correcta investigación de los casos de IRAS, atendiendo a los diferentes factores asociados a su ocurrencia, resultando evidente la necesidad de mayor vigilancia epidemiológica de las infecciones en la Unidad de Cuidadps Intensivos. The present study aims to characterize the cases of Infections related to health care Occurred in an adult ICU. A descriptive, exploratory, documental and quantitative tipe. The sample consisted of medical records and files Of infection control of the CCIH of all cases of infections occurred in the ICU of Hospital Universitário Getúlio Vargas in Manaus - Amazonas from January 2013 to December 2014. Seventy-five patients were selected, Being the majority belonging to the female sex (60%), With predominance of the elderly (36.5%). They were classified as surgical (45.3%) and had ICU stay of 16 or more days (42.7%). Regarding the profile of infections, there were predominant respiratory tract infections (46.2%) and blood flow (26.6%), calling attention to associated pneumonia with Mechanical Ventilation (35.2%). The study also showed that there is a predominance of clinical, laboratory and imaging diagnosis in the identification of IRAS, adding up to 62.4%, neglecting to perform cultures 37.5%. Among the identified microorganisms there is a predominance of gram-negative 28.1%. The highest occurrence of infection by invasive devices occurred in the use of the orotracheal tube 48%. There was a strong and significant correlation between the death outcome and the amount of infections present (p=0,02) and the number of pathogens isolated in each patient (p=0,03). The correct investigation of IRAS cases is essential, considering the different factors associated with its occurrence, evidencing the need for greater epidemiological surveillance of infections in the Intensive Care Unit.

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Mortality and risks related to healthcare-associated infection

Cited by 45 publications

References 23 publications

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Sepsis in a university hospital: a prospective study for the cost analysis of patients' hospitalization

Nursing workload and occurrence of adverse events in intensive care: a systematic review

Infección relacionada con la Asistencia a la Salud en Unidad de Cuidados Intensivos Adulto

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