Why focus on infection control in Critical Care?
In adult critical care ten percent of MRSA bacteraemia are identified in service users, according to the Health Protection Agency.
Critically ill service users have an increased risk for central venous catheter (CVC) related infections, hospital associated pneumonias, and other infections relating to ineffective infection prevention and control measures.
Infections have a major impact on patient morbidity and mortality and can increase length of stay in critical care units and hospitals generally. This can, in turn, raise pressure on critical care capacity and resources.
In a study undertaken in Michigan (an intervention to decrease catheter-related bloodstream infections in the ICU, http://content.nejm.org/cgi/content/abstract/355/26/2725, application of best practice in infection prevention and control measures within critical care resulted in a large and sustained reduction of up to 66% in rates of catheter-related bloodstream infections. This was maintained throughout an 18-month period and resulted in savings of approximately £8,300 – £37,500 per infection.
How can we reduce healthcare associated infections in critical care?
As in all areas of care, no single action will produce effective infection prevention and control practice. Sustainable reductions in healthcare associated infections (HCAIs) require the engagement and active involvement of all staff working within the critical care environment, supported by the infection control team and clinical champions.
The following high impact interventions will be particularly useful to staff working in critical care environments:
- Central venous catheter care
- Peripheral intravenous canula care
- Renal dialysis catheter care
- Prevention of surgical site infection
- Care for ventilated patients (or tracheostomies where appropriate)
- Urinary catheter care
- Reducing the risk of Clostridium difficile
- Cleaning and decontamination of clinical equipment
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