Trends in late‐onset sepsis in a neonatal intensive care unit following implementation of infection control bundle: A 15‐year audit

Pharande, Pramod; Lindrea, Kwee Bee; Smyth, John; Evans, Margaret; Lui, Kei; Bolisetty, Srinivas

doi:10.1111/jpc.14078

Cited by 9 publications

(8 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Important outcome measures include mortality, readmission, patient and family experience, and staff outcomes. Outcome measures in ICUs include mortality, outcomes of infection control, prevention of gastrointestinal bleeding and pressure ulcers, prevalence of sepsis, central line‐associated bloodstream infections (Lee et al., 2019; Pharande et al., 2018), ventilator‐acquired pneumonia (VAP) and catheter‐related bloodstream infections. ICU staff outcomes include morale, productivity and job satisfaction (Cummings et al., 2018).…”

Section: Quality Measures In Intensive Care Unitsmentioning

confidence: 99%

Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review

et al. 2020

View full text Add to dashboard Cite

Aim To examine the impact of nursing leadership styles on intensive care unit quality measures. Background Evidence on the impact of leadership styles has direct implications for building and strengthening leadership behaviours that foster quality nursing care in intensive care units. Evaluation An integrative review approach was adopted. Databases including the Cumulative Index of Nursing and Allied Health Literature, PubMed, Scopus, ProQuest, Google Scholar and the Cochrane Library were searched. Key issues(s) Out of 253 identified studies, seven were included in the review. Leadership styles in intensive care units include transformational, considerate, exemplary, trusted and absentee leadership. Active nurse leaders who share a common vision, and advocate for their staff are perceived as more effective than those who exhibit absentee characteristics. Structural measures influenced by leadership styles include productivity and morale of nursing staff. Outcome measures such as staff outcomes (intent to stay, job satisfaction), medication errors and periventricular/intraventricular haemorrhage in neonatal intensive care units have a positive relational effect with nursing leadership style. Conclusions The findings highlight the link between nursing leadership styles on structural and outcome measures in intensive care units. The current literature lacks studies highlighting the impact of nursing leadership styles on process measures in intensive care units. Implications for nursing management Transformational, considerate, exemplary leadership practices, and trusted leadership styles when used by nurse leaders guarantee higher quality of nursing care in intensive care units. Therefore, modern leadership styles need to be supported by health care organisations and education.

show abstract

Section: Quality Measures In Intensive Care Unitsmentioning

confidence: 99%

Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review

et al. 2020

View full text Add to dashboard Cite

show abstract

“…It has been confirmed that the introduction of the bundles is associated with a reduction in late-onset systemic infections among infants in the NICU [83,84,85]. The bundles, constructed separately for individual procedures or periods of care, are written locally to better adapt them to the specificities of a unit.…”

Section: Resultsmentioning

confidence: 99%

“…The bundles when applied together, result in substantially greater improvement. For example, activities of the central line bundle, as described by Pharande, include strict hand hygiene, maximal sterile barrier precautions, proper skin antisepsis, aseptic technique, optimal site choice for line insertion, transparent sterile dressing, surveillance, and documentation [85]. According to the authors, implementation of the bundle during a 15-year period resulted in a constant decline in the incidence of LOS and CLABSI in their NICU, in spite of an increase in admissions to the NICU, an increase in central line utilization, and no decrease in the number of high-risk infants.…”

Section: Resultsmentioning

confidence: 99%

Neonate Bloodstream Infections in Organization for Economic Cooperation and Development Countries: An Update on Epidemiology and Prevention

Wójkowska‐Mach

Chmielarczyk

Strus

et al. 2019

JCM

View full text Add to dashboard Cite

The term neonatal sepsis is used to describe a generalized bloodstream infection of bacterial, viral, or fungal origin which is associated with hemodynamic changes and other clinical symptoms and signs, however, there is no unified definition. There are no basic criteria regarding differentiation of early-onset sepsis (EOS) versus late-onset sepsis (LOS). Stratification used in studies on neonatal sepsis also rarely includes the general condition of the newborn according to unambiguous assessment at birth, which hampers the establishment of a clear, uniform epidemiological description of neonatal sepsis. We aim to review the published data about the epidemiology and microbiology of sepsis in Organization for Economic Cooperation and Development (OECD) countries. Data was also collected on sepsis prevention programs that can be implemented in neonatal units. The outcomes of interest were incidence or incidence density of EOS and LOS, microbiology of EOS and LOS, and data on the methodology of the research, in particular the criteria for inclusion and exclusion of newborns from the study. Pubmed, EMBASE, LILACS Embase, Scopus, and Google Scholar were used. For the preselection step, inclusion criteria included: “bloodstream infection” or “neonatal sepsis” (MesH), “very low birth weight”, and “country” full-text studies, human, and English language. Exclusion criteria included: studies published in languages other than English and studies available only as an abstracts. For proper selection, inclusion criteria included: information about epidemiology or microbiology bloodstream infection (BSI), study population and case definitions, exclusion criteria, narrative reviews, commentaries, case studies, pilot studies, study protocols, pediatric studies, and only clinical data (without microbiology or epidemiology) or studies with only one etiological factor analysis. The data review indicated the lack of an unequivocal, unified definition and no unambiguous basic criteria with regard to differentiation of EOS versus LOS. Among infants <1500 g, studies reported an EOS rate from 7% to 2%. For studies using other definitions (mostly all inborn babies), the rate of EOS ranged from 1% to 3%. The LOS incidences were much more varied among countries; the highest rates were in the multicenter studies focused on very low birth weight (VLBW) infants. The main pathogens in EOS are GBS and Gram-negative bacteria in LOS. Our review data shows that LOS microbiology is very diverse and that Gram-positive cocci, especially staphylococci, predominate versus Gram-negative rods. Unfortunately, the lack of uniform, international prevention programs results in high newborn morbidity and insufficient postnatal prevention of late-onset infections.

show abstract

“…Central line placement, used for administration of parenteral nutrition and antibiotics, risks the introduction of pathogens to the bloodstream and is the likely cause of many BSIs. As such, increased hygienic practices implemented in hospitals have resulted in a stark decrease in LOS caused by normal skin commensals [7]. However, despite these efforts, LOS rates in neonates remain unchanged among cases caused by gut commensals, suggesting the bacteria are entering the bloodstream through another mechanism [7].…”

Section: Introductionmentioning

confidence: 99%

“…As such, increased hygienic practices implemented in hospitals have resulted in a stark decrease in LOS caused by normal skin commensals [7]. However, despite these efforts, LOS rates in neonates remain unchanged among cases caused by gut commensals, suggesting the bacteria are entering the bloodstream through another mechanism [7].…”

Section: Introductionmentioning

confidence: 99%

Understanding the Elements of Maternal Protection from Systemic Bacterial Infections during Early Life

Kleist

Knoop

2020

Nutrients

View full text Add to dashboard Cite

Late-onset sepsis (LOS) and other systemic bloodstream infections are notable causes of neonatal mortality, particularly in prematurely born very low birth weight infants. Breastfeeding in early life has numerous health benefits, impacting the health of the newborn in both the short-term and in the long-term. Though the known benefits of an exclusive mother’s own milk diet in early life have been well recognized and described, it is less understood how breastfed infants enjoy a potential reduction in risk of LOS and other systemic infections. Here we review how gut residing pathogens within the intestinal microbiota of infants can cause a subset of sepsis cases and the components of breastmilk that may prevent the dissemination of pathogens from the intestine.

show abstract

Trends in late‐onset sepsis in a neonatal intensive care unit following implementation of infection control bundle: A 15‐year audit

Abstract: Multifaceted infection control bundle practices with a concerted team effort in the implementation, with continuing education, feedback and reinforcement of best infection control practices, can sustain the gains achieved by infection control for a long period of time.

Cited by 9 publications

References 28 publications

Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review

Nursing leadership styles and their impact on intensive care unit quality measures: An integrative review

Neonate Bloodstream Infections in Organization for Economic Cooperation and Development Countries: An Update on Epidemiology and Prevention

Understanding the Elements of Maternal Protection from Systemic Bacterial Infections during Early Life

Contact Info

Product

Resources

About