Impact of an Educational Intervention Implanted in a Neurological Intensive Care Unit on Rates of Infection Related to External Ventricular Drains

Camacho, Eduardo Fernandes; Boszczowski, Ícaro; Freire, Maristela Pinheiro; Pinto, Fernando Campos Gomes; Guimaraes, Thais; Teixeira, Manuel Jacobsen; Costa, Silvia Figueiredo
February 2013
PLoS ONE;Feb2013, Vol. 8 Issue 2, p1
Academic Journal
Background: Studies on the implantation of care routines showed reduction on EVD catheter-related infections rates; however zero tolerance is difficult to be achieved. The objective of this study was to assess the impact of an educational intervention on the maximal reduction on rates of EVD-related infections. Methodology/Principal Findings: The quasi-experimental (before-after intervention) study occurred in two phases: pre-intervention, from April 2007 to July 2008, and intervention, from August 2008 to July 2010. Patients were followed for 30 days after the removal of the EVD, and EVD-related infections were considered as only those with laboratorial confirmation in the CSF. Observations were made of the care of the EVD and compliance with Hygiene of the Hands (HH), a routine of care was drawn up, training was given, and intervention was made to reduce the time the EVD catheter remained in place. Results: during the study, 178 patients were submitted to 194 procedures, corresponding to 1217 EVD catheters-day. Gram-negative agents were identified in 71.4% of the infections during the pre-intervention period and in 60% during the intervention period. During the study, EVD-related infection rates were reduced from 9.5% to 4.8% per patient, from 8.8% to 4.4% per procedure, and the incidence density dropped from 14.0 to 6.9 infections per 1000 catheters-day (p = 0.027). The mortality reduced 12% (from 42% to 30%). Conclusions/Significance: During one year after the fourth intervention, no microbiologically identified infection was documented. In light of these results, educational intervention proved to be a useful tool in reducing these rates and showed also impact on mortality.


Related Articles

  • NEUROLOGY & NEUROSURGERY.  // U.S. News & World Report;7/12/2004, Vol. 137 Issue 1, p106 

    Presents a list of the top 50 neurology and neurosurgery units at hospitals in the United States as of July 2004.

  • The Early Days of the Neurosciences Intensive Care Unit. WIJDICK, EELCO F. M.; WORDEN, WENDY R.; MIERS, ANNE G.; PIEPGRAS, DAVID G. // Mayo Clinic Proceedings;Sep2011, Vol. 86 Issue 9, p903 

    The article focuses on the formation of intensive care units (ICUs). It states that the excessive care for sicker people created the need of the formation of ICUs. The first neuroscience intensive care unit (NICU) was established by the neurosurgeon Walter Dandy at Saint Marys Hospital in 1932....

  • Organization of neurology services in India: Unmet needs and the way forward. Gourie-Devi, Mandaville // Neurology India;Jan-Mar2008, Vol. 56 Issue 1, p4 

    Recognition of the magnitude of the burden and disability and mortality consequent to neurological disorders has led to global initiatives of declaring them as a "global epidemic", emphasizing public health approach and integration of neurology care with general health care. Epidemiological...

  • Nosocomial Infections in a Neurological Intensive Care Unit. Buke, Cagri; Biyikli, Bilge; Tuncel, Murside; Aydemir, Sohret; Tunger, Alper; Sirin, Hadiye; Kocaman, Ayse Sagduyu // Journal of Neurological Sciences;2009, Vol. 26 Issue 3, p298 

    Background: Nosocomial infections in intensive care units are common and associated with high morbidity, mortality. This study was planned to evaluate the occurance and causes of site specific nosocomial infections in a neurological intensive care unit (NICU) and their relevance to underlying...

  • Where Different Worlds Collide: Expanding the Influence of Research and Researchers on Policy. Moodie, Rob // Journal of Public Health Policy;2009 Supplement 1, Vol. 30, pS33 

    The author reflects on how public health researches can convince policy makers to implement health programs based on their research. He provides an overview of the research conducted in Melbourne, Victoria on women's health and the successful health program in India which was embedded on a...

  • Managed clinical networks: delivering the NSF. Thomas, Sue // Primary Health Care;May2005, Vol. 15 Issue 4, p22 

    Focuses on the needs to be addressed in order to put the National Service Framework for Mental Health for long term conditions into practice in Great Britain. Importance of the development of clinical neuroscience networks as solution for commissioning neurology services for the future; Details...

  • Unsafe at any speed. Kaiser, Charles // Advocate;7/6/2004, Issue 918, p72 

    The article presents the author's opinion about the rising HIV infection rates in the U.S. Gay men and the federal government seem to be locked in an unacknowledged conspiracy to increase HIV infection rates. Gay men are doing their part by advertising their eagerness to party and play, as...

  • HIV Drug Resistance Early Warning Indicators in Namibia for Public Health Action. Jonas, Anna; Gweshe, Justice; Siboleka, Milner; DeKlerk, Michael; Gawanab, Michael; Badi, Alfons; Sumbi, Victor; Pereko, Dawn; Blom, Abraham; Mwinga, Samson; Jordan, Michael R.; Jerger, Logan; Lau, Kiger; Hong, Steven Y. // PLoS ONE;Jun2013, Vol. 8 Issue 6, p1 

    Background: HIV drug resistance (HIVDR) testing is not routinely available in many resource-limited settings, therefore antiretroviral therapy (ART) program and site factors known to be associated with emergence of HIVDR should be monitored to optimize the quality of patient care and minimize...

  • Changing role of the neurologist. Thrush, David C.; Pryse-Phillips, William // British Medical Journal (Clinical Research Edition);11/28/1981, Vol. 283 Issue 6304, p1450 

    Focuses on the role of the neurologist in the management of neurological disorders. Prevention of the social and psychological chronic disability; Details on the management of patients with different complications; Idiosyncracies on the part of the author's publication.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics