• Title/Summary/Keyword: Healthcare-associated bloodstream infection

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Catheter-related bloodstream infections in neonatal intensive care units

  • Lee, Jung-Hyun
    • Clinical and Experimental Pediatrics
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    • v.54 no.9
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    • pp.363-367
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    • 2011
  • Central venous catheters (CVCs) are regularly used in intensive care units, and catheter-related bloodstream infection (CRBSI) remains a leading cause of healthcare-associated infections, particularly in preterm infants. Increased survival rate of extremely-low-birth-weight infants can be partly attributed to routine practice of CVC placement. The most common types of CVCs used in neonatal intensive care units (NICUs) include umbilical venous catheters, peripherally inserted central catheters, and tunneled catheters. CRBSI is defined as a laboratory-confirmed bloodstream infection (BSI) with either a positive catheter tip culture or a positive blood culture drawn from the CVC. BSIs most frequently result from pathogens such as gram-positive cocci, coagulase-negative staphylococci, and sometimes gram-negative organisms. CRBSIs are usually associated with several risk factors, including prolonged catheter placement, femoral access, low birth weight, and young gestational age. Most NICUs have a strategy for catheter insertion and maintenance designed to decrease CRBSIs. Specific interventions slightly differ between NICUs, particularly with regard to the types of disinfectants used for hand hygiene and appropriate skin care for the infant. In conclusion, infection rates can be reduced by the application of strict protocols for the placement and maintenance of CVCs and the education of NICU physicians and nurses.

Evaluation of the Effectiveness of Surveillance on Improving the Detection of Healthcare Associated Infections (의료관련감염에서 감시 개선을 위한 평가)

  • Park, Chang-Eun
    • Korean Journal of Clinical Laboratory Science
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    • v.51 no.1
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    • pp.15-25
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    • 2019
  • The development of reliable and objective definitions as well as automated processes for the detection of health care-associated infections (HAIs) is crucial; however, transformation to an automated surveillance system remains a challenge. Early outbreak identification usually requires clinicians who can recognize abnormal events as well as ongoing disease surveillance to determine the baseline rate of cases. The system screens the laboratory information system (LIS) data daily to detect candidates for health care-associated bloodstream infection (HABSI) according to well-defined detection rules. The system detects and reserves professional autonomy by requiring further confirmation. In addition, web-based HABSI surveillance and classification systems use discrete data elements obtained from the LIS, and the LIS-provided data correlates strongly with the conventional infection-control personnel surveillance system. The system was timely, acceptable, useful, and sensitive according to the prevention guidelines. The surveillance system is useful because it can help health care professionals better understand when and where the transmission of a wide range of potential pathogens may be occurring in a hospital. A national plan is needed to strengthen the main structures in HAI prevention, Healthcare Associated Prevention and Control Committee (HAIPCC), sterilization service (SS), microbiology laboratories, and hand hygiene resources, considering their impact on HAI prevention.

The Incidences of Catheter Colonization and Central Line-Associated Bloodstream Infection According to Tegaderm vs. Chlorhexidine Gluconate (CHG)-Tegaderm Dressing (중심정맥관 번들이행에 따른 중심정맥관 균집락과 중심정맥관 관련 혈류감염: CHG테가덤과 일반테가덤 드레싱비교연구)

  • Kim, Eunji;Lee, Haejung
    • Journal of Korean Academy of Nursing
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    • v.50 no.4
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    • pp.541-553
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    • 2020
  • Purpose: In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. Methods: We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ2 test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. Results: In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. Conclusion: A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.

Knowledge and Performance Level of Infection Control and Influencing Factors of Oriental Medical Doctors and Nurses in Korea (한방병원 한의사와 간호사의 감염관리에 대한 지식과 수행도 비교)

  • Kim, Kyung-Mi;Kim, Hyeong-Jun;Choi, Jeong-Sil
    • Korean Journal of Adult Nursing
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    • v.24 no.1
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    • pp.74-84
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    • 2012
  • Purpose: This study was designed to identify knowledge and performance level of infection control among oriental medical doctors and nurses and further to identify factors that may influence practice. Methods: Data were collected using the survey method. Two hundred and forty two healthcare workers (HCW) from five oriental medicine university hospitals in Korea (140 physicians and 102 nurses) completed a survey about infection control. The study was conducted from February 1 to 28, 2011. Results: The average knowledge level of infection control among HCW was $0.75{\pm}0.13$ (score range 0~1) and the average performance level of infection control was $3.16{\pm}1.05$ (score range 0~5). 'Disinfection and sterilization' were ranked the highest in both the knowledge and performance level. In the knowledge level, 'hand washing/hand hygiene' were ranked the lowest. 'Bloodstream infection prevention' was the lowest among the infection control categories in performance. Total average knowledge and performance level of nurses was significantly higher than that of the physicians. Conclusion: This study demonstrated the oriental medical doctors and nurses' knowledge and performance level of infection control differed. The education on infection control is required to oriental medical doctors and nurses and it would contribute to preventing healthcare associated infections in oriental medicine hospitals.