Journal ArticleDOI
Infection control in the intensive care unit
Mohamed F. Osman,Reza Askari +1 more
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TLDR
A multifaceted approach, including infection prevention committees, antimicrobial stewardship programs, daily reassessments-intervention bundles, identifying and minimizing risk factors, and continuing staff education programs, is essential.About:
This article is published in Surgical Clinics of North America.The article was published on 2014-12-01. It has received 29 citations till now. The article focuses on the topics: Critical care nursing & Antimicrobial stewardship.read more
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Journal ArticleDOI
Efficacy of antiseptic-impregnated central venous catheters in preventing catheter-related bloodstream infection. A Meta-analysis
TL;DR: In this paper, the authors evaluated the efficacy of chlorhexidine-silver sulfadiazine-impregnated central venous catheters in the prevention of catheter-related bloodstream infection.
The role of understaffing in central venous catheter-associated bloodstream infections [see comments]
S. Fridkin,SM Pear +1 more
Abstract: OBJECTIVE
To determine risk factors for central venous catheter-associated bloodstream infections (CVC-BSI) during a protracted outbreak.
DESIGN
Case-control and cohort studies of surgical intensive care unit (SICU) patients.
SETTING
A university-affiliated Veterans Affairs medical center.
PATIENTS
Case-control study: all patients who developed a CVC-BSI during the outbreak period (January 1992 through September 1993) and randomly selected controls. Cohort study: all SICU patients during the study period (January 1991 through September 1993).
MEASUREMENTS
CVC-BSI or site infection rates, SICU patient clinical data, and average monthly SICU patient-to-nurse ratio.
RESULTS
When analyzed by hospital location and site, only CVC-BSI in the SICU had increased significantly in the outbreak period compared to the previous year (January 1991 through December 1991: pre-outbreak period). In SICU patients, CVC-BSI were associated with receipt of total parenteral nutrition [TPN]; odds ratio, 16; 95% confidence interval, 4 to 73). When we controlled for TPN use, CVC-BSI were associated with increasing severity of illness and days on assisted ventilation. SICU patients in the outbreak period had shorter SICU and hospital stays, were younger, and had similar mortality rates, but received more TPN compared with patients in the pre-outbreak period. Furthermore, the patient-to-nurse ratio significantly increased in the outbreak compared with the pre-outbreak period. When we controlled for TPN use, assisted ventilation, and the period of hospitalization, the patient-to-nurse ratio was an independent risk factor for CVC-BSI in SICU patients.
CONCLUSIONS
Nursing staff reductions below a critical level, during a period of increased TPN use, may have contributed to the increase in CVC-BSI in the SICU by making adequate catheter care difficult. During healthcare reforms and hospital downsizing, the effect of staffing reductions on patient outcome (i.e., nosocomial infection) needs to be critically assessed.
Journal ArticleDOI
Eradication of carbapenem-resistant Enterobacteriaceae gastrointestinal colonization with nonabsorbable oral antibiotic treatment: A prospective controlled trial.
Ilana Oren,H. Sprecher,Renato Finkelstein,Renato Finkelstein,Salim Hadad,Ami Neuberger,Keatam Hussein,Ayelet Raz-Pasteur,Noa Lavi,Elias Saad,Israel Henig,Netanel A. Horowitz,Irit Avivi,Irit Avivi,Noam Benyamini,Riva Fineman,Yishai Ofran,Yishai Ofran,Nuhad Haddad,Jacob M. Rowe,Jacob M. Rowe,Tsila Zuckerman,Tsila Zuckerman +22 more
TL;DR: Oral antibiotic treatment with nonabsorbable drugs to which CRE is susceptible appears to be an effective and safe for eradication of CRE colonization and, thereby, may reduce patient- to-patient transmission and incidence of clinical infection with this difficult-to-treat organism.
Journal Article
Glycaemic variability, infections and mortality in a medical-surgical intensive care unit
Abele Donati,Elisa Damiani,Roberta Domizi,L Botticelli,R Castagnani,Vincenzo Gabbanelli,Simonetta Nataloni,Andrea Carsetti,Claudia Scorcella,Erica Adrario,Paolo Pelaia,Jean-Charles Preiser +11 more
TL;DR: High GV is associated with higher risk of ICUCrit acquired infection and mortality and the areas under receiver operating characteristic curves were calculated to compare the discriminatory ability of GV and mean BGL for infections and mortality.
Journal ArticleDOI
Perioperative Temperature Management During Burn Care.
Julie A Rizzo,Matthew P. Rowan,Ian R Driscoll,Ian R Driscoll,Rodney K Chan,Rodney K Chan,Kevin K. Chung,Kevin K. Chung +7 more
TL;DR: Current evidence on the value of increasing ambient temperature during the care of severely burned patients in the operating room or intensive care unit is limited, with minimal human studies investigating physiologic benefit or potential adverse effects.
References
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Journal ArticleDOI
Intensive Insulin Therapy in Critically Ill Patients
Greet Van den Berghe,Pieter Wouters,Frank Weekers,Charles Verwaest,Frans Bruyninckx,Miet Schetz,Dirk Vlasselaers,Patrick Ferdinande,Peter Lauwers,Roger Bouillon +9 more
TL;DR: Intensive insulin therapy to maintain blood glucose at or below 110 mg per deciliter reduces morbidity and mortality among critically ill patients in the surgical intensive care unit.
Journal ArticleDOI
An intervention to decrease catheter-related bloodstream infections in the ICU
Peter J. Pronovost,Dale M. Needham,Sean M. Berenholtz,David J. Sinopoli,Haitao Chu,Sara E. Cosgrove,Bryan Sexton,Robert C. Hyzy,Robert J. Welsh,Gary Roth,Joseph Bander,John P. Kepros,Christine A. Goeschel +12 more
TL;DR: An evidence-based intervention resulted in a large and sustained reduction (up to 66%) in rates of catheter-related bloodstream infection that was maintained throughout the 18-month study period.
Journal ArticleDOI
Guideline for Hand Hygiene in Health-Care Settings. Recommendations of the Healthcare Infection Control Practices Advisory Committee and the HIPAC/SHEA/APIC/IDSA Hand Hygiene Task Force.
John M. Boyce,Didier Pittet +1 more
TL;DR: The Guideline for Hand Hygiene in Health-Care Settings provides health-care workers (HCWs) with a review of data regarding handwashing and hand antisepsis and provides specific recommendations to promote improved hand-hygiene practices and reduce transmission of pathogenic microorganisms to patients and personnel in health- Care settings.
Journal ArticleDOI
Clinical Practice Guidelines for Clostridium difficile Infection in Adults: 2010 Update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA)
Stuart H. Cohen,Dale N. Gerding,Stuart Johnson,Ciaran P. Kelly,Vivian G. Loo,L. Clifford McDonald,Jacques Pépin,Mark H. Wilcox +7 more
TL;DR: This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management of Clostridium difficile.
Journal ArticleDOI
International Study of the Prevalence and Outcomes of Infection in Intensive Care Units
Jean Louis Vincent,Jordi Rello,John C. Marshall,Eliezer Silva,Antonio Anzueto,Claude Martin,Rui Moreno,Jeffrey Lipman,Charles D. Gomersall,Yasser Sakr,Konrad Reinhart +10 more
TL;DR: In this large cohort, infection was independently associated with an increased risk of hospital death and risk of infection increases with duration of ICU stay.
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