The Effect of Infection Control Nurses on the Occurrence of Pseudomonas aeruginosa Healthcare-Acquired Infection and Multidrug-Resistant Strains in Critically-Ill Children

Abstract

BackgroundHealthcare-acquired Pseudomonas aeruginosa (P. aeruginosa) infections in the Pediatric Intensive Care Unit (PICU), which have a high incidence, increase treatment costs and mortality, and seriously threaten the safety of critically ill children. It is essential to seek convenient and effective methods to control and prevent healthcare-acquired infections (HAIs). This research was conducted to study the effect of infection control nurses on the occurrence of P. aeruginosa HAIs and multi-drug resistance (MDR) strains in PICU.MethodsThe clinical data was divided into two groups, with the age ranging from 1 month to 14 years. One group of the critically ill patients(N = 3,722) was admitted to PICU from 2007 to 2010, without the management of infection control nurses. The other group of the critically ill patients (N = 3,943) was admitted to PICU from 2011 to 2013, with the management of infection control nurses. Compare the mortality, morbidity and the incidence of acquired P. aeruginosa infections to evaluate the effect of infection control nurses.ResultsAfter implementation of the post of infection control nurses, the patient's overall mortality fell from 4.81% to 3.73%. Among the patients with endotracheal intubation more than 48 hours, the incidence of endotracheal intubation-related pneumonia decreased from 44.6% to 34.32%. The mortality of patients with endotracheal intubation decreased from 16.96% to 10.17%, and the morbidity of HAIs with P. aeruginosa decreased from 1.89% to 1.07%. The mutual different rate (MDR) dropped from 67.95% to 44.23%. There were remarkable differences in these rates between the two groups (p<0.05).ConclusionImplementing the post of infection control nurses is associated with effectively reducing the HAI rate, especially the incidence and morbidity of P. aeruginosa HAIs, reducing PICU mortality, improving P. aeruginosa drug resistance.

Healthcare-associated infections including neonatal bloodstream infections in a leading tertiary hospital in Botswana

“…The overall point prevalence of HAIs in this hospital was 13.5%, which is similar or lower than other LMICs [4,13,[15][16][17]44]. Not surprisingly, a higher prevalence of HAIs occurred in the intensive care and dialysis units (Table 1) consistent with other studies [15,[44][45][46][47]. The majority of the patients admitted to the ICU and neonatal ICU had undergone invasive procedures, had more complicated conditions with a long period of hospitalization and had long-term use of antibiotics predisposing them to the risk of acquiring multidrug-resistant infections.…”

What we can do? The risk factors for multi-drug resistant infection in pediatric intensive care unit (PICU): a case-control study

“…In conclusion, this present study has revealed that coma, parenteral nutrition, 2 or more antibiotics use and the duration of mechanical ventilation > 5 days are independent risk factors associated with MDRIs in PICU. Based on the evidence provided in this study, specific actions can be taken to improve prevention of MDRIs, such implementing the post of infection control nurses et al [42], which may significantly reduce the MDRIs. The evidences provided can help critical care providers in PICU determine the extent to which they can modify their treatment strategies to achieve optimal clinical outcomes.…”

Estratégias de enfermeiros gerentes para prevenção e controle de infecções relacionadas à assistência à saúde

“…Com esta ação também é possível identificar fragilidades e elaborar estratégias, como observado em uma pesquisa realizada na China (Chan et al, 2016), o qual refere-se à vigilância como uma competência básica, em que os profissionais supervisionaram à adequada higienização das mãos da equipe de saúde, bem como a observação de sinais e sintomas de possíveis riscos de infecção dentre os pacientes, instituindo quando necessário o isolamento. Além disso, nesta pesquisa foi possível observar a certificação de que não haja a reutilização de produtos médicos descartáveis, a implementação da desinfecção de estetoscópios, e outros equipamentos para diagnósticos (Xu et al, 2015).…”

“…Outra estratégia implementada pelos enfermeiros do setor de controle de infecção é a Educação Permanente, prática que pode, e deve ser realizada para os profissionais de saúde em geral, como enfermeiros, fisioterapeutas, médicos, profissionais da higienização e funcionários administrativos (Xu et al, 2015), onde é realizada uma reciclagem e aperfeiçoamento das técnicas e atividades exercidas, em que o profissional de enfermagem assume uma postura integradora em seu cotidiano de trabalho para prevenir as infecções hospitalares. A educação permanente exercida por enfermeiros dentro do âmbito hospitalar vai muito além de treinamento dos profissionais, ela é dispensada também para pacientes e familiares, onde estes são instruídos como se portarem diante de uma situação de precaução de contato ou respiratória.…”