External ventricular drain practice variations: results from a nationwide survey
| Autor: | Griffin R. Baum, Kristopher G. Hooten, Dennis T. Lockney, Kyle M. Fargen, Nefize Turan, Gustavo Pradilla, Gregory J. A. Murad, Robert E. Harbaugh, Michael Glantz |
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| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Nationwide survey Ventriculostomy 03 medical and health sciences 0302 clinical medicine Humans Surgical Wound Infection Infection control Medicine 030212 general & internal medicine Protocol (science) business.industry Incidence General Medicine Infection rate Test (assessment) Surgery Health Care Surveys Emergency medicine Respondent Drainage business Complication 030217 neurology & neurosurgery Hydrocephalus External ventricular drain |
| Zdroj: | Journal of Neurosurgery. 127:1190-1197 |
| ISSN: | 1933-0693 0022-3085 |
| DOI: | 10.3171/2016.9.jns16367 |
| Popis: | OBJECTIVEWhile guidelines exist for many neurosurgical procedures, external ventricular drain (EVD) insertion has yet to be standardized. The goal of this study was to survey the neurosurgical community and determine the most frequent EVD insertion practices. The hypothesis was that there would be no standard practices identified for EVD insertion or methods to avoid EVD-associated infections.METHODSThe American Association of Neurological Surgeons membership database was queried for all eligible neurosurgeons. A 16-question, multiple-choice format survey was created and sent to 7217 recipients. The responses were collected electronically, and the descriptive results were tabulated. Data were analyzed using the chi-square test.RESULTSIn total, 1143 respondents (15.8%) completed the survey, and 705 respondents (61.6%) reported tracking EVD infections at their institution. The most common self-reported infection rate ranged from 1% to 3% (56.1% of participants), and 19.7% of respondents reported a 0% infection rate. In total, 451 respondents (42.7%) indicated that their institution utilizes a formal protocol for EVD placement. If a respondent's institution had a protocol, only 258 respondents (36.1%) always complied with the protocol. Protocol utilization for EVD insertion was significantly more frequent among residents, in academic/hybrid centers, in ICU settings, and if the institution tracked EVD-associated infection rates (p < 0.05). A self-reported 0% infection rate was significantly more commonly associated with a higher level of training (e.g., attending physicians), private center settings, a clinician performing 6 to 10 EVD insertions within the previous 12 months, and prophylactic continuous antibiotic utilization (p < 0.05).CONCLUSIONSThis survey demonstrated heterogeneity in the practices for EVD insertion. No standard practices have been proposed or adopted by the neurosurgical community for EVD insertion or complication avoidance. These results highlight the need for the nationwide standardization of technique and complication prevention measures. |
| Databáze: | OpenAIRE |
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