Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of ventilator-associated pneumonia in intensive care units of two hospitals in Kuwait.

Autor:	Al-Mousa, Haifaa Hassan, Omar, Abeer Aly, Rosenthal, Víctor Daniel, Salama, Mona Foda, Aly, Nasser Yehia, El-Dossoky Noweir, Mohammad, Rebello, Flavie Maria, Narciso, Dennis Malungcot, Sayed, Amani Fouad, Kurian, Anu, George, Sneha Mary, Mohamed, Amna Mostafa, Ramapurath, Ruby Jose, Varghese, Suga Thomas, Orellano, Pablo Wenceslao
Předmět:	CONFIDENCE intervals CONSORTIA STATISTICAL correlation EPIDEMIOLOGICAL research FISHER exact test HAND washing HEALTH education INTENSIVE care units INTERNATIONAL agencies LONGITUDINAL method EVALUATION of medical care MEDICAL cooperation PERSONNEL management PUBLIC health surveillance RESEARCH RESEARCH funding T-test (Statistics) LOGISTIC regression analysis DISEASE incidence DATA analysis software ODDS ratio VENTILATOR-associated pneumonia PREVENTION
Zdroj:	Journal of Infection Prevention; Jul2018, Vol. 19 Issue 4, p168-176, 9p
Abstrakt:	Objective: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach (IMA) on ventilator-associated pneumonia (VAP) rates in three intensive care units (ICUs) from two hospitals in Kuwait City from January 2014 to March 2015. Design: A prospective, before–after study on 2507 adult ICU patients. During baseline, we performed outcome surveillance of VAP applying CDC/NHSN definitions. During intervention, we implemented the IMA through the INICC Surveillance Online System (ISOS), which included: (1) a bundle of infection prevention interventions; (2) education; (3) outcome surveillance; and (4) feedback on VAP rates and consequences. Logistic regression analysis was performed to estimate the effect of the intervention on VAP, controlling for potential bias. Results: During baseline, 1990 mechanical ventilator (MV)-days and 14 VAPs were recorded, accounting for 7.0 VAPs per 1000 MV-days. During intervention, 9786 MV-days and 35 VAPs were recorded, accounting for 3.0 VAPs per 1000 MV-days. The VAP rate was reduced by 57.1% (incidence-density ratio = 0.51; 95% CI = 0.28–0.93; p = 0.042). Logistic regression showed a significant reduction in VAP rate during the intervention phase (OR = 0.39, 95% CI = 0.18–0.83), with 61% effectiveness. Conclusions: Implementing IMA through ISOS was associated with a significant reduction in the VAP rate in Kuwait ICUs. [ABSTRACT FROM AUTHOR]
Databáze:	Complementary Index
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