Impact of an Educational Intervention Implanted in a Neurological Intensive Care Unit on Rates of Infection Related to External Ventricular Drains

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art_CAMACHO_Impact_of_an_Educational_Intervention_Implanted_in_a_2013.PDF (266.43 KB)
Citações na Scopus
37
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article
Data de publicação
2013
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Scopus
Web of Science
PubMed
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PUBLIC LIBRARY SCIENCE
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PLOS ONE, v.8, n.2, article ID e50708, 7p, 2013
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Unidades Organizacionais
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Resumo
Background: Studies on the implantation of care routines showed reduction on EVD catheter-related infections rates; however zero tolerance is difficult to be achieved. The objective of this study was to assess the impact of an educational intervention on the maximal reduction on rates of EVD-related infections. Methodology/Principal Findings: The quasi-experimental (before-after intervention) study occurred in two phases: pre-intervention, from April 2007 to July 2008, and intervention, from August 2008 to July 2010. Patients were followed for 30 days after the removal of the EVD, and EVD-related infections were considered as only those with laboratorial confirmation in the CSF. Observations were made of the care of the EVD and compliance with Hygiene of the Hands (HH), a routine of care was drawn up, training was given, and intervention was made to reduce the time the EVD catheter remained in place. Results: during the study, 178 patients were submitted to 194 procedures, corresponding to 1217 EVD catheters-day. Gram-negative agents were identified in 71.4% of the infections during the pre-intervention period and in 60% during the intervention period. During the study, EVD-related infection rates were reduced from 9.5% to 4.8% per patient, from 8.8% to 4.4% per procedure, and the incidence density dropped from 14.0 to 6.9 infections per 1000 catheters-day (p = 0.027). The mortality reduced 12% (from 42% to 30%). Conclusions/Significance: During one year after the fourth intervention, no microbiologically identified infection was documented. In light of these results, educational intervention proved to be a useful tool in reducing these rates and showed also impact on mortality.
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https://observatorio.fm.usp.br/handle/OPI/2009
Referências
  1. Arabi Y, 2005, AM J INFECT CONTROL, V33, P137, DOI 10.1016/j.ajic.2004.11.008
  2. BOGDAHN U, 1992, NEUROSURGERY, V31, P898
  3. Bota DP, 2005, J NEUROSURG, V103, P468, DOI 10.3171/jns.2005.103.3.0468
  4. Chi H, 2010, INT J INFECT DIS, V14, P216
  5. Dasic D, 2006, BRIT J NEUROSURG, V20, P296, DOI 10.1080/02688690600999901
  6. Girao E, 2008, INT J INFECT, V12, P145
  7. Hoefnagel D, 2008, ACTA NEUROCHIR, V150, P209, DOI 10.1007/s00701-007-1458-9
  8. Holloway KL, 1996, J NEUROSURG, V85, P419, DOI 10.3171/jns.1996.85.3.0419
  9. Honda H, 2010, INFECT CONT HOSP EP, V31, P1078, DOI 10.1086/656377
  10. Horan TC, 2008, AM J INFECT CONTROL, V36, P309, DOI 10.1016/j.ajic.2008.03.002
  11. Korinek AM, 2005, ACTA NEUROCHIR, V147, P39, DOI 10.1007/s00701-004-0416-z
  12. Krol V, 2009, J Hosp Infect, V71, P176, DOI 10.1016/j.jhin.2008.09.018
  13. Leverstein-van Hall MA, 2010, J NEUROSURG, V112, P345, DOI 10.3171/2009.6.JNS09223
  14. Levin AS, 1999, CLIN INFECT DIS, V28, P1008, DOI 10.1086/514732
  15. Lietard C, 2008, J NEUROSURG, V109, P729, DOI 10.3171/JNS/2008/109/10/0729
  16. Lobo RD, 2005, AM J INFECT CONTROL, V33, P83, DOI 10.1016/j.ajic.2004.05.003
  17. Lobo RD, 2010, AM J INFECT CONTROL, V38, P440, DOI 10.1016/j.ajic.2009.09.013
  18. Maniker AH, 2006, NEUROSURGERY, V59, P419, DOI 10.1227/01.NEU.0000222817.99752.E6
  19. MAYHALL CG, 1984, NEW ENGL J MED, V310, P553, DOI 10.1056/NEJM198403013100903
  20. Park P, 2004, NEUROSURGERY, V55, P594, DOI 10.1227/01.NEU.0000134289.04500.EE
  21. Pfisterer W, 2003, J NEUROL NEUROSUR PS, V74, P929, DOI 10.1136/jnnp.74.7.929
  22. Pronovost P, 2006, NEW ENGL J MED, V355, P2725, DOI 10.1056/NEJMoa061115
  23. Rebuck JA, 2000, J NEUROL NEUROSUR PS, V69, P381, DOI 10.1136/jnnp.69.3.381
  24. Schade RP, 2005, J NEUROSURG, V102, P229, DOI 10.3171/jns.2005.102.2.0229
  25. [Anonymous], 2006, M100S16 CLSI

Coleções
Artigos e Materiais de Revistas Científicas - FM/MNE
Artigos e Materiais de Revistas Científicas - FM/MIP
Artigos e Materiais de Revistas Científicas - HC/ICESP
Artigos e Materiais de Revistas Científicas - HC/ICHC
Artigos e Materiais de Revistas Científicas - HC/IPq
Artigos e Materiais de Revistas Científicas - LIM/26
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