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Effect of Education on the Rate of and the Understanding of Risk Factors for Intravascular Catheter–Related Infections

Published online by Cambridge University Press:  02 January 2015

G. Yilmaz ,
R. Caylan ,
K. Aydin ,
M. Topbas  and
I. Koksal
G. Yilmaz*
Affiliation:
Department of Infectious Diseases and Clinical Microbiology, Turkey
R. Caylan
Affiliation:
Karadeniz Technical University School of Medicine, Trabzon, and the Department of Infectious Diseases and Clinical Microbiology, Ankara Ataturk Education and Research Hospital, Ankara, Turkey
K. Aydin
Affiliation:
Department of Infectious Diseases and Clinical Microbiology, Turkey
M. Topbas
Affiliation:
Department of Public Health, Turkey
I. Koksal
Affiliation:
Department of Infectious Diseases and Clinical Microbiology, Turkey
*
Department of Infectious Diseases and Clinical Microbiology, Karadeniz Technical University School of Medicine, Trabzon 61100, Turkey ([email protected])
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Abstract

Objective.

Intravascular catheters are indispensable tools in modern medical therapy. In spite of their great benefits, however, the widespread use of catheters leads to several complications, including infections that cause significant morbidity, mortality, and economic losses for hospitalized patients.

Design.

This study was conducted at Farabi Hospital, a 495-bed facility at Karadeniz Technical University Medical School in Trabzon, Turkey, and involved 3 separate periods: preeducation, education, and posteducation. Patients with intravascular catheters were monitored daily, as were the results of their physical examinations. The information acquired was recorded in a questionnaire.

Results.

During the preeducation period (October 2003 through March 2004), 405 intravascular catheters inserted into 241 patients were observed for 5,445 catheter-days. Seventy-one cases of intravascular catheter-related infection (CRI) were identified, giving a CRI rate of 13.04 infections per 1,000 catheter-days. The catheter-related bloodstream infection (CRBSI) rate was 8.3 infections per 1,000 catheter-days, and the exit-site infection (ESI) rate was 3.5 infections per 1,000 catheter-days. During the posteducation period (June through November 2004), 365 intravascular catheters inserted into 193 patients were observed for 5,940 catheter-days. Forty-five cases of CRI were identified, giving a rate of 7.6 infections per 1,000 catheter-days. The CRBSI rate was 4.7 infections per 1,000 catheter-days, and the ESI rate was 2.2 infections per 1,000 catheter-days. When findings from the 2 periods were compared, it was determined that education reduced CRI incidence by 41.7%.

Conclusion.

CRI can be prevented when hospital personnel are well informed about these infections. We compared the knowledge levels of the relevant personnel in our hospital before and after theoretical and practical training and identified a significant increase in knowledge after training (P < .0001 ). Parallel to this, although still below ideal levels, we identified a significant improvement in the incidence of CRI during the posteducation period (P = .004). The rate was low for the first 3 months of this period but increased 2.08 times after the third month. In conclusion, regular training for the residents in charge of inserting intravascular catheters and the nurses and interns who maintain the catheters is highly effective in reducing the rate of CRI in large teaching hospitals.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 6 , June 2007 , pp. 689 - 694
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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References

1.Henderson, DK. Infections due to percutaneous intravascular devices. In: Mandell, GL, Bennett, JE, Dolin, R, eds. Principles and Practice of Infectious Diseases. 5th ed. Philadelphia: Churchill-Livingstone Inc., 2000:3005–3020.Google Scholar
2.Mermel, LA, Farr, BM, Sherertz, RJ, et al.Guidelines for the management of intravascular catheter-related infections. Clin Infect Dis 2001;32:1249–1272.Google Scholar
3.Polderman, KH, Girbes, AR. Central venous catheter use. Part 2: infectious complications. Intensive Care Med 2002;28:18–28.CrossRefGoogle ScholarPubMed
4.Cunha, BA. Intravenous line infections. Crit Care Clin 1998;14:339–346.Google Scholar
5.Lorente, L, Villegas, J, Martin, MM, Jimenez, A, Mora, ML. Catheter-related infection in critically inpatients. Intensive Care Med 2004;30:1681–1684.CrossRefGoogle Scholar
6.Raad, II, Sabbagh, MF, Rand, KH, Sherertz, RJ. Quantitative tip culture methods and the diagnosis of central venous catheter-related infections. Diagn Microbiol Infect Dis 1992;15:13–20.Google Scholar
7.O'Grady, NP, Alexander, M, Dellinger, EP, et al.Healthcare Infection Control Practices Advisory Committee: guidelines for the prevention of intravascular catheter-related infections. Infect Control Hosp Epidemiol 2002;23:759–769.CrossRefGoogle ScholarPubMed
8.National Nosocomial Infections Surveillance System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2004, issued October 2004. Am J Infect Control 2004;32:470–485.Google Scholar
9.dos Santos Silva, I. Overview of study designs. In: Cancer Epidemiology Principles and Methods. 2nd ed. Lyon, France: WHO-IARC, 1999:83–101.Google Scholar
10.Sitges-Serra, A. Strategies for prevention of catheter-related bloodstream infections. Support Care Cancer 1999;7:391–395.CrossRefGoogle ScholarPubMed
11.NNIS System. National Nosocomial Infections Surveillance (NNIS) System Report, data summary from January 1992 through June 2003, issued August 2003. Am J Infect Control 2003;31:481–498.CrossRefGoogle Scholar
12.Munoz, P, Bouza, E, San Juan, R, et al.Clinical-epidemiological characteristics and outcome of patients with catheter-related bloodstream infections in Europe (ESGNI-006 Study). Clin Microbiol Infect 2004;10:843–845.Google Scholar
13.Simon, A, Bindl, L, Kramer, MH. Surveillance of nosocomial infections: prospective study in a pediatric intensive care unit; background, patients and methods. Klin Padiatr 2000;212:2–9.CrossRefGoogle Scholar
14.Wallace, WC, Cinat, M, Gornick, WB, Lekawa, ME, Wilson, SE. Nosocomial infections in the surgical intensive care unit: a difference between trauma and surgical patients. Am Surg 1999;65:987–990.CrossRefGoogle ScholarPubMed
15.Gastmeier, P, Schumacher, M, Daschner, F, Ruden, H. An analysis of two prevalence surveys of nosocomial infection in German intensive care units. J Hosp Infect 1997;35:97–105.Google Scholar
16.Gastmeier, P, Hentschel, J, de Veer, I, Obladen, M, Ruden, H. Device-associated nosocomial infection surveillance in neonatal intensive care using specified criteria for neonates. J Hosp Infect 1998;38:51–60.CrossRefGoogle ScholarPubMed
17.Finkelstein, R, Rabino, G, Kassis, I, Mahamid, I. Device-associated, device-day infection rates in an Israeli adult general intensive care unit. J Hosp Infect 2000;44:200–205.Google Scholar
18.Khuri-Bulos, NA, Shennak, M, Agabi, S, et al.Nosocomial infections in the intensive care units at a university hospital in a developing country: comparison with National Nosocomial Infections Surveillance intensive care unit rates. Am J Infect Control 1999;27:547–552.Google Scholar
19.Singh-Naz, N, Sprague, BM, Patel, KM, Pollack, MM. Risk factors for nosocomial infection in critically ill children: a prospective cohort study. Crit Care Med 1996;24:875–878.Google Scholar
20.Dettenkofer, M, Ebner, W, Hans, FJ, et al.Nosocomial infections in a neurosurgery intensive care unit. Acta Neurochir (Wien) 1999;141:1303–1308.Google Scholar
21.Hosoglu, S, Akalin, S, Kidir, V, Suner, A, Kayabas, H, Geyik, MF. Prospective surveillance study for risk factors of central venous catheter-related bloodstream infections. Am J Infect Control 2004;32:131–134.Google Scholar
22.Inan, D, Saba, R, Yalcin, AN, Yilmaz, M, Ongut, G, Ramazanoglu, A, Mamikoglu, L. Device-associated nosocomial infection rates in Turkish medical-surgical intensive care units. Infect Control Hosp Epidemiol 2006;27:343–348.Google Scholar
23.Ersoz, G, Kaya, Z, Uguz, K, Bayarslan, C, Kandemir, O, Kaya, A. Mersin Üniversitesi Tip Fakültesi Hastanesinde Intravaskuler Kateter Kullanimi ve Iliskili Infeksiyon Hizlari. Flora 2004;9:204–208.Google Scholar
24.Warren, DK, Zack, IE, Mayfield, JL, et al.The effect of an education program on the incidence of central venous catheter-associated bloodstream infection in a medical ICU. Chest 2004;126:1612–1618.Google Scholar
25.Coopersmith, CM, Rebmann, TL, Zack, JE, et al.Effect of an education program on decreasing catheter-related bloodstream infections in the surgical intensive care unit. Crit Care Med 2002;30:59–64.Google Scholar
26.Sherertz, RJ, Ely, EW, Westbrook, DM, et al.Education of physicians-in-training can decrease the risk for vascular catheter infection. Ann Intern Med 2000;132:641–648.Google Scholar