Impact of Educational Intervention in the Frequency of Nosocomial Infection among Patients Admitted in ICU of Tertiary Care Hospital: Interventional Study: Improvement in Hospital Acquired Infections among ICU patients after Education

Muhammad  Azizullah; Ejaz Mahmood  Ahmad Qureshi; Muhammad  Saleem Rana; Asif  Hanif; Faisal  Izhar; Ahmad  Humayun Asghar

doi:10.54393/pbmj.v5i6.481

Authors

Muhammad Azizullah Department of Public Health, University of Lahore, Pakistan
Ejaz Mahmood Ahmad Qureshi Department of Public Health, University of Lahore, Pakistan
Muhammad Saleem Rana Department of Public Health, University of Lahore, Pakistan
Asif Hanif Department of Public Health, University of Lahore, Pakistan
Faisal Izhar Department of Community Dentistry, FMH College of Dentistry, Lahore, Pakistan
Ahmad Humayun Asghar Department of Medicine, Govt. M. Nawaz Sharif Hospital, Lahore, Pakistan

DOI:

https://doi.org/10.54393/pbmj.v5i6.481

Keywords:

Educational intervention, Nosocomial Infection and Intensive Care Unit

Abstract

Infection is one of the leading causes of death in the world especially in low and lower-middle income countries. Objective: To determine the frequency of nosocomial infection in the Intensive Care Unit of a tertiary care teaching hospital, Lahore, Pakistan. Methods: Patients (n=270) were included in a study that was conducted in ICU of a tertiary care public sector, Jinnah Hospital, Lahore for a period of 18 months. Patients were divided into two groups (pre and post educational intervention). During this period, information about patient’s nosocomial infection rate, its distribution and patient’s excess length of stay in hospital collected. Data were analyzed using SPSS version 26.0. Chi-square Test was applied to find out the significance of nosocomial infection keeping P-value of ≤ 0.05 as significant. Results: Total of 115 (42.6%) were males and 155 (57.4%) were females. Results showed 42 (15.9%) out of 270 participants suffered in Nosocomial Infection/Hospital Acquired Infection during treatment and stay in ICU. Conclusion: It was concluded that educational intervention played a significant role in controlling the nosocomial infection among patients admitted in the ICU.

References

Shaikh JM, Devrajani BR, Shah SZA, Akhund T, Bibi I. Frequency, pattern and etiology of nosocomial infection in intensive care unit: an experience at a tertiary care hospital. Journal of Ayub Medical College Abbottabad. 2008 Dec; 20(4):37-40.

Lozano R, Naghavi M, Foreman K, Lim S, Shibuya K, Aboyans V, et al. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010: a systematic analysis for the Global Burden of Disease Study 2010. Lancet. 2012 Dec; 380(9859):2095-128. doi: 10.1016/S0140-6736(12)61728-0.

Martin-Loeches I, Wunderink RG, Nanchal R, Lefrant JY, Kapadia F, Sakr Y, et al Determinants of time to death in hospital in critically ill patients around the world. Intensive Care Medicine. 2016 Sep; 42(9):1454-60. doi: 10.1007/s00134-016-4479-0.

Corrêa RA, José BPS, Malta DC, Passos VMA, França EB, Teixeira RA, et al. Burden of disease by lower respiratory tract infections in Brazil, 1990 to 2015: estimates of the Global Burden of Disease 2015 study. Revista Brasileira de Epidemiologia. 2017 May;2 0Suppl 01(Suppl 01):171-181. Portuguese, English. doi: 10.1590/1980-5497201700050014.

Haque A, Ahmed SA, Rafique Z, Abbas Q, Jurair H, Ali SA. Device-associated infections in a paediatric intensive care unit in Pakistan. Journal of Hospital Infection. 2017 Jan; 95(1):98-100. doi: 10.1016/j.jhin.2016.10.021.

Saleem Z, Hassali MA, Godman B, Hashmi FK, Saleem F. A multicenter point prevalence survey of healthcare-associated infections in Pakistan: findings and implications. American Journal of Infection Control. 2019 Apr; 47(4):421-424. doi: 10.1016/j.ajic.2018.09.025.

Bell T, O'Grady NP. Prevention of central line-associated bloodstream infections. Infectious Disease Clinics of North America. 2017 Sep; 31(3):551-559. doi: 10.1016/j.idc.2017.05.007.

Keane S, Martin-Loeches I. Host-pathogen interaction during mechanical ventilation: systemic or compartmentalized response? Critical Care. 2019 Jun; 23(Suppl 1):134. doi: 10.1186/s13054-019-2410-0.

Parker V, Giles M, Graham L, Suthers B, Watts W, O'Brien T, et al. Avoiding inappropriate urinary catheter use and catheter–associated urinary tract infection (CAUTI): a pre-post control intervention study. BMC Health Services Research. 2017 May; 17(1):314. doi: 10.1186/s12913-017-2268-2.

Chaudhry D, Prajapat B. Intensive care unit bugs in India: how do they differ from the western world. Journal of Association of Chest Physicians.2017 Jan; 5(1):10.

Qadeer A, Akhtar A, Ain QU, Saadat S, Mansoor S, Assad S, et al. Antibiogram of medical intensive care unit at tertiary care hospital setting of Pakistan. Cureus. 2016 Sep; 8(9): e809. doi: 10.7759/cureus.809.

World Health Organization (WHO). Report on the burden of endemic health care-associated infection worldwide. Geneva: WHO; 2011.

Walter J, Haller S, Quinten C, Kärki T, Zacher B, Eckmanns T, et al. Healthcare-associated pneumonia in acute care hospitals in European Union/European Economic Area countries: an analysis of data from a point prevalence survey, 2011 to 2012. Euro Surveillance. 2018 Aug; 23(32):1700843. doi: 10.2807/1560-7917.ES.2018.23.32.1700843.

Cassini A, Plachouras D, Eckmanns T, Abu Sin M, Blank HP, Ducomble T, et al. Burden of six healthcare-associated infections on european population health: estimating incidence-based disability-adjusted life years through a population prevalence-based modelling study. PLoS Medicine. 2016 Oct; 13(10): e1002150. doi: 10.1371/journal.pmed.1002150.

Magill SS, Edwards JR, Bamberg W, Beldavs ZG, Dumyati G, Kainer MA, et al. Multistate point-prevalence survey of health care–associated infections. New England Journal of Medicine 2014 Mar7; 370(13):1198-208. doi: 10.1056/NEJMoa1306801.

Imran M, Amjad A, Haidri FR. Frequency of hospital acquired pneumonia and its microbiological etiology in medical intensive care unit. Pakistan Journal of Medical Sciences. Pakistan Journal of Medical Sciences. 2016 Aug; 32(4):823-6. doi: 10.12669/pjms.324.8942.

Abramczyk ML, Carvalho WB, Medeiros EAS. Preventing catheter-associated infections in the pediatric intensive care unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital. Brazilian Journal of Infectious Diseases. 2011 Dec; 15(6):573-7. doi: 10.1590/s1413-86702011000600012.

Jia H, Li L, Li W, Hou T, Ma H, Yang Y, et al. Impact of Healthcare-Associated Infections on Length of Stay: A Study in 68 Hospitals in China. Biomed Research International. 2019 Apr; 2019:2590563. doi: 10.1155/2019/2590563.

Ohannessian R, Gustin MP, Bénet T, Gerbier-Colomban S, Girard R, Argaud L, et al. Estimation of Extra Length of Stay Attributable to Hospital-Acquired Infections in Adult ICUs Using a Time-Dependent Multistate Model. Critical Care Medicine. 2018 Jul; 46(7):1093-1098. doi: 10.1097/CCM.0000000000003131.

Karkhane M, Pourhosiengholi MA, Torkabad MR, Kimiia Z, Mortazavi SM, Aghdam SK, et al. Annual antibiotic related economic burden of healthcare associated infections; a cross-sectional population based study. Iranian Journal of Pharmaceutical Research: IJPR. 2016; 15(2): 605.

Al-Mousa HH, Omar AA, Rosenthal VD, Salama MF, Aly NY, El-Dossoky Noweir M, et al.Device-associated infection rates, bacterial resistance, length of stay, and mortality in Kuwait: International Nosocomial Infection Consortium findings. American Journal of Infection Control. 2016 Apr; 44(4):444-9. doi: 10.1016/j.ajic.2015.10.031.

Vardakas KZ, Rafailidis PI, Konstantelias AA, Falagas ME. Predictors of mortality in patients with infections due to multi-drug resistant Gram negative bacteria: the study, the patient, the bug or the drug? Journal of Infection. 2013 May; 66(5):401-14. doi: 10.1016/j.jinf.2012.10.028.

Gandra S, Barter DM, Laxminarayan R. Economic burden of antibiotic resistance: how much do we really know? Clinical Microbiology and Infection. 2014 Oct; 20(10):973-80. doi: 10.1111/1469-0691.12798.

Rosenthal VD, Olarte N, Torres-Hernandez H, Villamil-Gomez W. Catheter-associated blood stream infection rates, extra length of stay and mortality in 69 adult ICUs of 37 cities of 11 developing countries. Findings of the INICC. American Journal of Infection Control. 2007 Jun; 35(5): E68-9.

Soares Pinheiro FGM, Santana Santos E, Barreto ÍDC, Weiss C, Vaez AC, Oliveira JC, et al. Mortality Predictors and Associated Factors in Patients in the Intensive Care Unit: A Cross-Sectional Study. Critical Care Research and Practice. 2020 Aug; 2020:1483827. doi: 10.1155/2020/1483827.

Mitsogianni M, Vasileiadis I, Parisi M, Tzanis G, Kampisiouli E, Psaroudaki et al. A Multifaceted Intervention Program to Prevent Bloodstream Infection in an Intensive Care Unit Running Head: An Intervention for the Reduction of Bacteraemia in ICU. Health Science Journal. 2016; 10(2):1.