Study reveals inadequate infection control in ICUs

February 13, 2014

A new study has shown that many intensive care units (ICUs) in hospitals across the US are falling short in terms of their infection prevention policies.

The research, published in the American Journal of Infection Control, was the largest of its kind and involved a team from Columbia University. The group partnered with the Centre for Disease Control and Prevention (CDC) to complete their survey of 1,534 ICUs at 975 hospitals across the US.

It was part of a larger study entitled Prevention of Nosocomial Infections and Cost Effectiveness Refined (P-NICER). The research encompassed 16 prescribed infection prevention measures at point-of-care, and clinician adherence to these policies for the prevention of central line-associated bloodstream infections (CLABSI), ventilator-associated pneumonia (VAP), and catheter-associated urinary tract infections (CAUTI). 

These infections are some of the most regularly acquired by patients in ICUs but, according to the survey, US hospitals have more procedures to prevent CLABSI and VAP, than CAUTI. 

Across the hospitals surveyed, the number that had that had infection control policies to prevent CLABSI ranged from 87 to 97 per cent, depending on the measure being counted. Policies concerning VAP prevention ranged from 69 to 91 per cent, while those for CAUTI lagged behind with only 27 to 68 per cent of ICUs reporting prevention policies. 

“Evidence-based practices related to CAUTI prevention measures have not been well implemented,” according to the authors.

“These findings are surprising, given that CAUTI is the most frequent healthcare-associated infection. Clearly, more focus on CAUTI is needed, and dissemination and implementation studies to inform how best to improve evidence-based practices should be helpful.”

The research found that many hospitals fell short in terms of adhering to prevention policies. This ranged from from 37 to 71 per cent for CLABSI, 45 to 55 per cent for VAP, and just six to 27 per cent for CAUTI, reports Infection Control Today.

“Previous studies have found that an extremely high rate of clinician adherence to infection prevention policies is needed to lead to a decrease in healthcare-associated infections. Unfortunately, the hospitals that monitored clinician adherence reported relatively low rates of adherence,” added the authors.

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