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: | Flavie Maria Rebello, Pablo Wenceslao Orellano, Suga Thomas Varghese, Amani Fouad Sayed, Mona Foda Salama, Haifaa H. Al-Mousa, Nasser Yehia A. Aly, Victor D. Rosenthal, Amna Mostafa Mohamed, Mohammad El-Dossoky Noweir, Sneha Mary George, Anu Kurian, Ruby Jose Ramapurath, Abeer Aly Omar, Dennis Malungcot Narciso |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
0301 basic medicine
Advanced and Specialized Nursing medicine.medical_specialty business.industry Health Policy 030106 microbiology Public Health Environmental and Occupational Health Ventilator-associated pneumonia Original Articles bacterial infections and mycoses medicine.disease Nosocomial infection control Hospital-acquired pneumonia respiratory tract diseases 03 medical and health sciences Pneumonia 0302 clinical medicine Infectious Diseases Intensive care Emergency medicine medicine 030212 general & internal medicine business |
| Zdroj: | Journal of Infection Prevention. 19:168-176 |
| ISSN: | 1757-1782 1757-1774 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|