Critical care hospital acquired infection

[anurseuk]

Hi,

Has anyone got any information on recent initiative to reduce hospital acquired infection particulaly in critical care?

Also, anyone got any thoughts on why critical care patients are more prone to infections?

Thanks:D

[XB9S, BSN, MSN, EdD, RN, APN]

Hi there, it may be worth having a look at some of the work done on the safer patient initiative in the UK as this addresses infection control issues as one of the initiatives and will be relevent to your work area as you are UK based.

There are quite a few pilot trusts that you could contact the SPI co-ordinator and they will be able to give you lots of data and infection prevention information that they are currently implementing.

As far as critical care patients being more at risk of hospital aquired infections, these pateints are your most vunerable and will have some level of compromised immunity due to the severity of thier illness.

[iluvivt, BSN, RN]

I know a lot about the infections acquired from all types of venous and arterial access lines. A lot of these infections come from not only vascular access lines but multiple other portals of entry. In addition,a majority of ICU pts have comorbitities. Check out the Institute for healthcare improvement they have a great site with many suggesstions and campaigns to reduce infection rates

[BBFRN, BSN, PhD]

http://www.ihi.org/ihi

Here's the website mentioned above. iluvivt is correct- they are a great resource. Check out their bundle resources for IV related infection control.

[PICC ACE]

Do a search on "VAP",ventilator associated pneumonia and you will find plenty of studies on strategies to reduce the risk of respiratory infections in the ventilated patient.

If you want something more innovative,one of the more compelling recent studies on infections in the ICU found that using Chlorhexidine for bathing the patient reduces the infection risk:

Effectiveness of chlorhexidine bathing to reduce catheter-associated bloodstream infections in medical ICU patients

Arch Intern Med. 2007;167:2073-2079

The authors conclude that "daily cleansing of MICU patients with CHG-impregnated cloths is a simple and effective strategy to decrease the rate of primary BSIs. We believe this approach is a useful adjunctive infection control measure".

There are currently a number of centers attempting to replicate these findings. (I just wish mine were one of them!)