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- Title
Impact of a multidimensional International Nosocomial Infection Control Consortium (INICC) approach on ventilator-associated pneumonia rates and mortality in Intensive Care Units in a Malaysian hospital.
- Authors
Chin Seng GAN; RAI, Vineya; ROSENTHAL, Víctor Daniel; Chai See LUM, Lucy; Wenceslao ORELLANO, Pablo; HASAN, Mohd Shahnaz; MANSOR, Marzida; Soo Lin CHUAH; Hadi JAMALUDDIN, Mohd Fadhil; ABDUL AZIZ, Fadzlina; Yap Mei Hoon; ZAINAL ABIDIN, Anis Siham; ZAMAN, Mazuin Kamarul; Wan Nurbayah WAN YUSOFF; Sasheela Sri La Sri Ponnampala; Othman, Ainul Auzani; ZAINOL, Hasimah; ZHAZALI, Rosliza; KAMARULZAMAN, Adeeba
- Abstract
Background: To analyze the impact of a multidimensional infection control approach and the use of the International Nosocomial Infection Control Consortium (INICC) Surveillance Online System (ISOS) on the rates of ventilator-associated pneumonia (VAP) and mortality in Malaysia from November 2013 to July 2015. Methods: A prospective, before-after study of 1,532 patients of 1 adult intensive care unit (ICU) and 1 pediatric ICU. During baseline, we performed outcome surveillance of VAP applying the CDC/NHSN definitions. During intervention, we implemented the INICC multidimensional approach and ISOS, including: 1) a bundle of infection prevention interventions; 2) education; 3) outcome surveillance; 4) process surveillance; 5) feedback on VAP rates and consequences; and 6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of intervention on VAP. Results: The baseline VAP rate of 27.2 per 1000 mechanical ventilator (MV)-days -- with 956 MV-days and 26 VAPs--, was reduced to 12.9 --with 2,100 MV-days and 104 VAPs, showing a 53% VAP rate reduction (RR 0.47; 95%CI 0.27-0.81; P 0.006). The mortality rate of 18.8% was reduced by 40% to 11.2% (RR 0.60; 95%CI 0.41-0.86; P 0.005). Conclusions: Implementing the INICC multidimensional infection control approach for VAP prevention was associated with a significant reduction in the rate of VAP and mortality in ICUs of Malaysia.
- Subjects
MALAYSIA; MORTALITY prevention; VENTILATOR-associated pneumonia; PREVENTION of communicable diseases; CONFIDENCE intervals; CROSS infection; INTENSIVE care units; LONGITUDINAL method; REGRESSION analysis; RESEARCH funding; LOGISTIC regression analysis; DESCRIPTIVE statistics; PREVENTION
- Publication
Canadian Journal of Infection Control / Revue Canadienne de Prévention des Infections, 2016, Vol 31, Issue 4, p230
- ISSN
1183-5702
- Publication type
Article