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Evaluation of a New Method of Detection of Nosocomial Infection in the Pediatric Intensive Care Unit: The Infection Control Sentinel Sheet System

Published online by Cambridge University Press:  21 June 2016

E.L. Ford-Jones ,
C.M. Mindorff ,
E. Pollock ,
R. Milner ,
D. Bohn ,
J. Edmonds ,
G. Barker  and
R. Gold
E.L. Ford-Jones*
Affiliation:
Division of Infection Diseases, Department of Pediatric., The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
C.M. Mindorff
Affiliation:
Division of Infection Diseases, Department of Pediatric., The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
E. Pollock
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
R. Milner
Affiliation:
Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
D. Bohn
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
J. Edmonds
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
G. Barker
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
R. Gold
Affiliation:
Division of Infection Diseases, Department of Pediatric., The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
*
Division of Infectious Disease, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, CanadaM5G 1X8
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Abstract

To improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).

Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 11 , November 1989 , pp. 515 - 520
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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