Effectiveness of simple daily sensitization of physicians to the duration of central venous and urinary tract catheterization

Autor: Aurélie Coué, Philippe Seguin, Sonia Isslame, Yannick Mallédant, Bruno Laviolle
Přispěvatelé: Foie, métabolismes et cancer, Université de Rennes (UR)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Pharmacologie du Sepsis et Choc Septique, Centre d'Investigation Clinique [Rennes] (CIC), Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes (UR)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes], CHU Pontchaillou [Rennes]-CHU Pontchaillou [Rennes], Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Structure Fédérative de Recherche en Biologie et Santé de Rennes ( Biosit : Biologie - Santé - Innovation Technologique ), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université de Rennes 1 (UR1), Université de Rennes (UNIV-RENNES)-Université de Rennes (UNIV-RENNES)-Hôpital Pontchaillou-Institut National de la Santé et de la Recherche Médicale (INSERM)-Service de Pharmacologie [Rennes]
Rok vydání: 2010
Předmět:
Male
Time Factors
medicine.medical_treatment
Urinary tract catheter
Critical Care and Intensive Care Medicine
0302 clinical medicine
Infection rate
Interquartile range
Prospective Studies
MESH: Incidence
030212 general & internal medicine
Practice Patterns
Physicians'
Prospective cohort study
Cross Infection
MESH: Catheterization
Central Venous
0303 health sciences
MESH: Middle Aged
Incidence
Incidence (epidemiology)
Middle Aged
Duration of catheterization
3. Good health
Intensive Care Units
Catheter
Anesthesia
Female
Urinary Catheterization
Central venous catheter
Catheterization
Central Venous
Critical Care
Reminder Systems
Urinary system
MESH: Reminder Systems
Urinary catheterization
03 medical and health sciences
Intensive care
medicine
Humans
MESH: Intensive Care
MESH: Physician's Practice Patterns
MESH: Humans
030306 microbiology
business.industry
MESH: Time Factors
MESH: Cross Infection
[SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology
MESH: Prospective Studies
MESH: Male
MESH: Urinary Catheterization
MESH: Intensive Care Units
business
MESH: Female
Zdroj: Intensive Care Medicine
Intensive Care Medicine, 2010, 36 (7), pp.1202-6. ⟨10.1007/s00134-010-1829-1⟩
Intensive Care Medicine, Springer Verlag, 2010, 36 (7), pp.1202-6. ⟨10.1007/s00134-010-1829-1⟩
ISSN: 1432-1238
0342-4642
Popis: International audience; PURPOSE: To evaluate the effectiveness of simple daily sensitization of physicians to the duration of central venous and urinary tract catheterization, and impact on infection rates. METHODS: A prospective, before-after study in a surgical intensive care unit. All consecutive patients who had a central venous catheter (CVC) and/or urinary tract catheter (UTC) were included during two consecutive periods. Period 1 (August 2005 to May 2006) served as the control period. During Period 2 (July 2006 to April 2007), a red square, added to the patient's daily care sheet, questioned the physician about the utility of the CVC and/or UTC. If the response was "No", the CVC and/or the UTC were removed by a nurse. RESULTS: A total of 1,271 patients were analyzed (Period 1, n = 676; Period 2, n = 595). The duration of catheterization (median [interquartile range]) was significantly reduced in Period 2 compared to Period 1 (from (5 [3-9] to 4 [3-7] days, p < 0.001, for CVC, and from 5 [3-11] to 4 [3-8] days, p < 0.001, for UTC). The incidence and density incidence of CVC infection decreased in Period 2 compared to Period 1 (from 1.8% to 0.3%, p = 0.010, and from 2.8 to 0.7/1,000 CVC-days, p = 0.051) whereas UTC infections were not significantly different (4.3 to 3.0%, p = 0.230, and 5.0 to 4.9/1,000 UTC-days, p = 0.938, respectively). CONCLUSIONS: A simple daily reminder to physicians on the patients' care sheets decreased the duration of central venous and urinary tract catheterization, and tended to decrease CVC infection rate without affecting UTC infection.
Databáze: OpenAIRE
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