دورية أكاديمية
Effectiveness of a multimodal strategy to reduce external ventricular drain-associated infection: A quasi-experimental study.
| العنوان: | Effectiveness of a multimodal strategy to reduce external ventricular drain-associated infection: A quasi-experimental study. |
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| المؤلفون: | Pongkaew C; Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Noiphithak R; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Rukskul P; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Yodwisithsak P; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Tantongtip D; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Nimmannitya P; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Punyarat P; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Duangprasert G; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Kaewwichai W; Neurosurgical Intensive Care Unit, Nursing Department, Thammasat University Hospital, Khlong Luang, Pathum Thani, Thailand., Songphul S; General Neurosurgical Unit, Nursing Department, Thammasat University Hospital, Khlong Luang, Pathum Thani, Thailand., Chancharoenrat W; Infection Control Department, Thammasat University Hospital, Khlong Luang, Pathum Thani, Thailand., Jantarathaneewat K; Research Group in Infectious Diseases Epidemiology and Prevention, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand; Department of Pharmaceutical Care, Faculty of Pharmacy, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Chokaouychai C; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Sukhor S; Division of Neurosurgery, Department of Surgery, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand., Apisarnthanarak P; Division of Diagnostic Radiology, Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand., Camins BC; Division of Infectious Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA., Weber DJ; University of North Carolina, Gillings School of Global Public Health, Chapel Hill, NC, USA., Apisarnthanarak A; Division of Infectious Diseases, Department of Internal Medicine, Faculty of Medicine, Thammasat University, Khlong Luang, Pathum Thani, Thailand; Infection Control Department, Thammasat University Hospital, Khlong Luang, Pathum Thani, Thailand. Electronic address: anapisarn@yahoo.com. |
| المصدر: | American journal of infection control [Am J Infect Control] 2024 Jul 03. Date of Electronic Publication: 2024 Jul 03. |
| Publication Model: | Ahead of Print |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Mosby Country of Publication: United States NLM ID: 8004854 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1527-3296 (Electronic) Linking ISSN: 01966553 NLM ISO Abbreviation: Am J Infect Control Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: St. Louis, Mosby |
| مستخلص: | Background: Infection is a serious complication in neurosurgical patients who undergo external ventricular drain (EVD) insertion. Methods: We conducted a quasi-experimental study in patients who underwent EVD insertion to evaluate the impact of a multi-modal strategy to reduce the incidence of external ventricular drain associated infections (EVDAIs). The study was divided into 2 periods; (1) the pre-intervention period when techniques for EVD insertion and maintenance were up to the discretion of the neurosurgeons and (2) the post-intervention after implementation of a multi-modal strategy (cefazolin antibiotic prophylaxis, preoperative chlorhexidine showers, application of postoperative chlorhexidine-impregnated dressing, limited manipulation of the EVD, and meticulous EVD management). The primary outcome was the incidence rate of EVDAIs; secondary outcomes included in-hospital mortality rate, the hospital length of stay. Results: In total, 135 patients were included. The incidence rate of EVDAIs was significantly reduced in the post-intervention period (5.6 cases/1,000 EVD-days) compared with the pre-intervention period (18.2 cases/1,000 EVD-days; P=0.026). There were no differences in all secondary outcomes analyzed. This multi-modal strategy was associated with high satisfaction among health care personnel. Conclusions: Implementation of a multi-modal strategy was associated with a reduction in the incidence of EVDAIs. This was in line with our goal of promoting a new culture of safety despite being in a resource-limited setting. (Copyright © 2024 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Bundle; Healthcare-associated infections; Infection prevention; Neurosurgery; Resource-limited settings |
| تواريخ الأحداث: | Date Created: 20240705 Latest Revision: 20240718 |
| رمز التحديث: | 20240718 |
| DOI: | 10.1016/j.ajic.2024.06.026 |
| PMID: | 38969072 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder | تدمد: | 1527-3296 |
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| DOI: | 10.1016/j.ajic.2024.06.026 |