Article (Scientific journals)
A continuous quality-improvement program reduces nosocomial infection rates in the ICU.
Misset, Benoît; Timsit, Jean-Francois; Dumay, Marie-Francoise et al.
2004In Intensive Care Medicine, 30 (3), p. 395-400
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Keywords :
Cross Infection/epidemiology/prevention & control; Guideline Adherence; Humans; Incidence; Infection Control/standards; Intensive Care Units/standards/statistics & numerical data; Paris/epidemiology; Population Surveillance; Proportional Hazards Models; Prospective Studies; Total Quality Management/methods
Abstract :
[en] OBJECTIVE: To assess the impact of a continuous quality-improvement program on nosocomial infection rates. DESIGN AND SETTING: Prospective single-center study in the medical-surgical ICU of a tertiary care center. PATIENTS. We admitted 1764 patients during the 5-year study period (1995-2000); 55% were mechanically ventilated and 21% died. Mean SAPS II was 37+/-21 points and mean length of ICU stay was 9.7+/-16.1 days. INTERVENTIONS: Implementation of an infection control program based on international recommendations. The program was updated regularly according to infection and colonization rates and reports in the literature. MEASUREMENTS AND RESULTS: Prospective surveillance showed the following rates per 1000 procedure days: ventilator-associated pneumonia (VAP) 8.7, urinary tract infection (UTI) 17.2, central venous catheter (CVC) colonization 6.1, and CVC-related bacteremia and 2.0; arterial catheter colonization did not occur. In the 5 years following implementation of the infection control program there was a significant decline in the rate per patient days of UTI, CVC colonization, and CVC-related bacteremia but not VAP. Between the first and second 2.5-year periods the time to infection increased significantly for UTI and CVC-related colonization. CONCLUSIONS: A continuous quality-improvement program based on surveillance of nosocomial infections in a nonselected medical-surgical ICU population was associated with sustained decreases in UTI and CVC-related infections.
Disciplines :
Anesthesia & intensive care
Author, co-author :
Misset, Benoît ;  Centre Hospitalier Universitaire de Liège - CHU > Service de Soins Intensifs
Timsit, Jean-Francois
Dumay, Marie-Francoise
Garrouste, Maite
Chalfine, Annie
Flouriot, Isabelle
Goldstein, Fred
Carlet, Jean
Language :
English
Title :
A continuous quality-improvement program reduces nosocomial infection rates in the ICU.
Publication date :
2004
Journal title :
Intensive Care Medicine
ISSN :
0342-4642
eISSN :
1432-1238
Publisher :
Springer, Heidelberg, Germany
Volume :
30
Issue :
3
Pages :
395-400
Peer reviewed :
Peer Reviewed verified by ORBi
Available on ORBi :
since 21 February 2020

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