Nurse-Physician Collaboration and Hospital-Acquired Infections in Critical Care

2015 ◽  
Vol 35 (2) ◽  
pp. 66-72 ◽  
Author(s):  
Christine Boev ◽  
Yinglin Xia
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Secondary Analysis ◽  
Bloodstream Infections ◽  
Unit Increase ◽  
Health Care Associated Infections ◽  
Critically Ill Adults ◽  
Hospital Acquired ◽  
Ill Adults

BackgroundNurse-physician collaboration may be related to outcomes in health care–associated infections. OBJECTIVE To examine the relationship between nurse-physician collaboration and health care–associated infections in critically ill adults.MethodsA secondary analysis was done of 5 years of nurses’ perception data from 671 surveys from 4 intensive care units. Ventilator-associated pneumonia and central catheter–associated bloodstream infections were examined. Multilevel modeling was used to examine relationships between nurse-physician collaboration and the 2 infections.ResultsNurse-physician collaboration was significantly related to both infections. For every 0.5 unit increase in collaboration, the rate of the bloodstream infections decreased by 2.98 (P= .005) and that of pneumonia by 1.13 (P= .005). Intensive care units with a higher proportion of certified nurses were associated with a 0.43 lower incidence of bloodstream infections (P= .02) and a 0.17 lower rate of the pneumonia (P= .01). With nursing hours per patient day as a covariate, units with more nursing hours per patient day were associated with a 0.42 decrease in the rate of bloodstream infections (P= .05).ConclusionNurse-physician collaboration was significantly related to health care–associated infections.

scholarly journals Caring for critically ill adults in paediatric intensive care units in England during the COVID-19 pandemic: planning, implementation and lessons for the future

2021 ◽  
pp. archdischild-2020-320962
Author(s):  
Ruchi Sinha ◽  
Angela Aramburo ◽  
Akash Deep ◽  
Emma-Jane Bould ◽  
Hannah L Buckley ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Clinical Care ◽  
Adult Patients ◽  
Paediatric Intensive Care ◽  
Critically Ill Adults ◽  
Care Capacity ◽  
Ill Adults ◽  
Paediatric Intensive Care Units

ObjectiveTo describe the experience of paediatric intensive care units (PICUs) in England that repurposed their units, equipment and staff to care for critically ill adults during the first wave of the COVID-19 pandemic.DesignDescriptive study.SettingSeven PICUs in England.Main outcome measures(1) Modelling using historical Paediatric Intensive Care Audit Network data; (2) space, staff, equipment, clinical care, communication and governance considerations during repurposing of PICUs; (3) characteristics, interventions and outcomes of adults cared for in repurposed PICUs.ResultsSeven English PICUs, accounting for 137 beds, repurposed their space, staff and equipment to admit critically ill adults. Neighbouring PICUs increased their bed capacity to maintain overall bed numbers for children, which was informed by historical data modelling (median 280–307 PICU beds were required in England from March to June). A total of 145 adult patients (median age 50–62 years) were cared for in repurposed PICUs (1553 bed-days). The vast majority of patients had COVID-19 (109/145, 75%); the majority required invasive ventilation (91/109, 85%). Nearly, a third of patients (42/145, 29%) underwent a tracheostomy. Renal replacement therapy was provided in 20/145 (14%) patients. Twenty adults died in PICU (14%).ConclusionIn a rapid and unprecedented effort during the first wave of the COVID-19 pandemic, seven PICUs in England were repurposed to care for adult patients. The success of this effort was underpinned by extensive local preparation, close collaboration with adult intensivists and careful national planning to safeguard paediatric critical care capacity.

scholarly journals Are mobile phones of health care workers portals of pathogenic organisms causing hospital acquired infections in intensive care units? A mini systematic review

2020 ◽  
Vol 47 (3) ◽  
pp. 207-214
Author(s):  
M. Mukhtar-Yola ◽  
B. Andrew
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Mobile Phones ◽  
Health Care Workers ◽  
Pathogenic Bacteria ◽  
Cross Sectional ◽  
Hospital Acquired Infections ◽  
Care Workers ◽  
Hospital Acquired

Background: Health care workers at the bedside of critically ill babies freely carry their mobile phones in between procedures and handling  patients. Concerns are rising as this may contribute to nosocomial infections with pathogenic bacteria. Aim: To determine if mobile phones of health care workers in Intensive care units carry potentially pathogenic bacteria leading to hospital acquired infections. Design: Systematic review.Data sources: Electronic databases (Medline via ovid, CINAHL, Web of science) and hand Searching of references and citations were done to identify studies. Screening and inclusion criteria were used to identify studies with a cross-sectional or cohort design. The search was limited to journal articles published between 2008-2015 and to English language. Quality assessment was done using the National Institute of Health tool for observational studies. Data was extracted on to excel sheets and analysed using SPSS version 22.Results: Six studies with a cohort (1) or cross-sectional design (5) involving 1, 131 health care workers were reviewed. The overall quality of the studies was fair, and a narrative synthesis was done. The colonization rate of the mobile phones ranged between 46.3 % and a 100% with 13-50% carrying potentially pathogenic multidrug resistant microorganisms. Methicillin resistant staphylococcus aureus, Vancomycine resistant enterococci, acinobacter and coagulase negative staphylococci were reported across all studies and were recognized as leading causes of morbidity and mortalityin the ICU. Conclusion: Mobile phones Of HCW are portals of potentially pathogenic microorganisms, which could result in morbidity and mortality.Although no causal relationship could be established, strong associations have been reported. Guidelines by hospital infection control committees are needed on restriction, care and routine cleaning of mobile phones as well as further research. Key words: Health care worker, Intensive care unit, Hospital Acquired Infections, mobile phones

scholarly journals Emerging Chryseobacterium indologenes Infection in Indian Neonatal Intensive Care Units: A Case Report

Antibiotics ◽  
2018 ◽  
Vol 7 (4) ◽  
pp. 109 ◽  
Author(s):  
Rishika Mehta ◽  
Ashish Pathak
Keyword(s):  
Health Care ◽  
Intensive Care ◽  
Intensive Care Units ◽  
Neonatal Intensive Care ◽  
Multidrug Resistant ◽  
Neonatal Intensive Care Units ◽  
Indwelling Catheters ◽  
Chryseobacterium Indologenes ◽  
Life Threatening ◽  
Health Care Associated Infections

Antibiotic-resistant pathogens and nosocomial infections constitute common and serious problems for neonates admitted to neonatal intensive care units worldwide. Chryseobacterium indologenes is a non-lactose-fermenting, gram-negative, health care-associated pathogen (HCAP). It is ubiquitous and intrinsically resistant to several antibiotics. Despite its low virulence, C. indologenes has been widely reported to cause life-threatening infections. Patients on chronic immunosuppressant drugs, harboring invasive devices and indwelling catheters become the nidus for C. indologenes. Typically, C. indologenes causes major health care-associated infections such as pneumonia, empyema, pyelonephritis, cystitis, peritonitis, meningitis, and bacteremia in patients harboring central venous catheters. Management of C. indologenes infection in neonates is not adequately documented owing to underreporting, particularly in India. Because of its multidrug resistance and the scant availability of data from the literature, the effective empirical treatment of C. indologenes is challenging. We present an uncommon case of bacteremia caused by C. indologenes in a preterm newborn baby with moderate respiratory distress syndrome who was successfully treated. We also provide a review of infections in the neonatal age group. Henceforth, in neonates receiving treatments involving invasive equipment use and long-term antibiotic therapy, multidrug resistant C. indologenes should be considered an HCAP.

scholarly journals Comparison of Total Hospital-Acquired Bloodstream Infections to Central Line–Associated Bloodstream Infections and Implications for Outcome Measures in Infection Control

2013 ◽  
Vol 34 (9) ◽  
pp. 984-986 ◽  
Author(s):  
Surbhi Leekha ◽  
Shanshan Li ◽  
Kerri A. Thom ◽  
Michael Anne Preas ◽  
Brian S. Caffo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Outcome Measures ◽  
Bloodstream Infections ◽  
Central Line ◽  
Total Hospital ◽  
Prevention Intervention ◽  
Hospital Acquired

The validity of the central line-associated bloodstream infection (CLABSI) measure is compromised by subjectivity. We observed significant decreases in both CLABSIs and total hospital-acquired bloodstream infections (BSIs) following a CLABSI prevention intervention in adult intensive care units. Total hospital-acquired BSIs could be explored as an adjunct, objective CLABSI measure.

Pain and Delirium in Critical Illness: An Exploration of Key 2018 SCCM PADIS Guideline Evidence Gaps

2019 ◽  
Vol 40 (05) ◽  
pp. 604-613 ◽  
Author(s):  
Margaret A. Pisani ◽  
John W. Devlin ◽  
Yoanna Skrobik
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Critical Illness ◽  
Intensive Care Units ◽  
Critically Ill ◽  
Critical Care Medicine ◽  
Sleep Disruption ◽  
Future Research ◽  
Critically Ill Adults ◽  
Ill Adults

AbstractManaging pain and delirium are crucial to patients, families, and caregivers in intensive care units. The Society of Critical Care Medicine 2018 Pain, Agitation/Sedation, Delirium, Immobility, and Sleep disruption (PADIS) guidelines reviewed literature until October 2015 and made its recommendations for critically-ill adults. This chapter addresses evidence gaps, identified during the guideline process, most relevant to clinicians, adds newer evidence published after the PADIS 2018 guidelines were produced, describes hindsight-driven PADIS process or content-related gaps, and reflects on how these considerations may help inform future research investigations and new guideline efforts.

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