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Impact of an educational program on reducing health care–associated meningitis or ventriculitis in the neurosurgical intensive care unit - 22/05/20

Doi : 10.1016/j.ajic.2019.10.012 
Yang Li, M, Med a, Rong Wang, M, Med b, Pei-Xin Song, MD c, Hai Ge, MBBS a, Yi-Chen Li, M, Med d, Cui-ling Ji, MBBS b, Yi-hong Jiang, MBBS a,
a Department of Nosocomial Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu, PR China 
b Department of Neurology Intensive Care Unit, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu, PR China 
c Department of Infectious Diseases, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu, PR China 
d Department of Pharmacy, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, Jiangsu, PR China 

Address correspondence to Yi-hong Jiang, MBBS, Department of Nosocomial Infection Control, Nanjing Drum Tower Hospital, The Affiliated Hospital of Nanjing University Medical School, 321 Zhongshan Rd, Nanjing, Jiangsu 210008, PR China.Department of Nosocomial Infection ControlNanjing Drum Tower HospitalThe Affiliated Hospital of Nanjing University Medical School321 Zhongshan RdNanjingJiangsu210008PR China

Highlights

Educational intervention decreased health care–associated meningitis, ventriculitis.
Coagulase-negative Staphylococcus was the most common causative pathogen.
There was an increase in Klebsiella spp incidence after the education intervention.

Il testo completo di questo articolo è disponibile in PDF.

Riassunto

Background

Health care–associated meningitis or ventriculitis (HCAMV) is a serious complication in different neurosurgical procedures and is associated with significant morbidity and mortality. We aimed to investigate whether an educational intervention program could reduce the HCAMV incidence in patients undergoing postsurgery external ventricular drainage and wound management.

Methods

We enrolled 2,904 patients from the neurosurgery intensive care unit between January 1, 2016 and December 31, 2018. The medical staff undertook an educational program developed by a multidisciplinary team on correct external ventricular drainage insertion and maintenance. The program included a 9-page self-learning module on the HCAMV risk factors and operational improvements. Each participant completed a pre- and posttest on their HCAMV knowledge.

Results

We found that 38 of 693 (5.48%) patients presented with infection in the preintervention 9-month period. In the 27-month postintervention period, the proportion of HCAMV incidence dropped by 52.19% (P < .0001) to 58 of 2,211 (2.62%) patients.

Conclusions

Educational intervention aimed at the neurosurgery intensive care unit staff could significantly reduce the HCAMV rate, leading to a significant decline in the cost, morbidity, and mortality caused by neurosurgical procedures.

Il testo completo di questo articolo è disponibile in PDF.

Key Words : Infection control, Neurosurgical procedures


Mappa


 Funding/support: The present study was supported by the Jiangsu Provincial Innovation Management of Hospital Research Projects (grant no. JSYGY-2-2018-189).
 Conflicts of interest: None to report.


© 2019  Association for Professionals in Infection Control and Epidemiology, Inc.. Pubblicato da Elsevier Masson SAS. Tutti i diritti riservati.
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Vol 48 - N° 6

P. 621-625 - giugno 2020 Ritorno al numero
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