본문 바로가기
KERD
논문KCI 등재후보

의료진 대상 리마인더 프로그램이 중환자실 중심정맥관 관련 혈류감염에 미치는 효과

Effects of Reminder Program for Healthcare Providers on Central Line-Associated Blood Stream Infection in an Intensive Care Unit

2

조회

0

다운로드

0

인용

0

참고문헌

키워드

주제분류간호학

초록

Purpose: This study aimed to develop a reminder program and evaluate the impacts of the program on adherence to maximal sterile barrier precautions (MBP), duration of catheterization, and central line-associated blood stream infection rates (CLA-BSIs). Methods: A simulated control group pretest-posttest design was used. The participants were 35 physicians, 17 nurses and 165 patients (control group=75, intervention group=90) with central catheter insertions for more than 48 hours admitted to a tertiary hospital. Data were collected from an university-affiliated hospital in Gwangju, South Korea. The intervention group received the reminder program which consisted of MBP adherence education, short message service (adherence feedback to MBP, optimal recommendation, and hand washing), and self-report checklist on central venous catheter management. Results: The adherence level of MBP was significantly increased from 87.7% to 97.9% (p=.026) after implementation of the reminder program. The duration of catheterization significantly decreased in the intervention group compared to the control group (from 10.6 to 7.4 days, p=.024). The incidence of CLA-BSI rate decreased in the intervention group compared to the control group but it was not statistically significant. Conclusion: This study showed some effectiveness of the reminder program to improve adherence of MBP and duration of catheterization among patients with central line. Further studies are needed to evaluate effects of the program on CLA-BSI rate using a randomized clinical trial with larger samples and diverse settings.

Abstract

Purpose: This study aimed to develop a reminder program and evaluate the impacts of the program on adherence to maximal sterile barrier precautions (MBP), duration of catheterization, and central line-associated blood stream infection rates (CLA-BSIs). Methods: A simulated control group pretest-posttest design was used. The participants were 35 physicians, 17 nurses and 165 patients (control group=75, intervention group=90) with central catheter insertions for more than 48 hours admitted to a tertiary hospital. Data were collected from an university-affiliated hospital in Gwangju, South Korea. The intervention group received the reminder program which consisted of MBP adherence education, short message service (adherence feedback to MBP, optimal recommendation, and hand washing), and self-report checklist on central venous catheter management. Results: The adherence level of MBP was significantly increased from 87.7% to 97.9% (p=.026) after implementation of the reminder program. The duration of catheterization significantly decreased in the intervention group compared to the control group (from 10.6 to 7.4 days, p=.024). The incidence of CLA-BSI rate decreased in the intervention group compared to the control group but it was not statistically significant. Conclusion: This study showed some effectiveness of the reminder program to improve adherence of MBP and duration of catheterization among patients with central line. Further studies are needed to evaluate effects of the program on CLA-BSI rate using a randomized clinical trial with larger samples and diverse settings.

참고문헌 (30)

  1. 김은진, "전국의료관련감염감시체계 중환자실 부문 결과 보고: 2018년 7월부터 2019년 6월", 의료관련감염관리, 25(2), pp.115~127 (2020), 대한의료관련감염관리학회[DOI]
  2. 곽이경, "전국의료관련감염감시체계 중환자실 부문 결과 보고: 2014년 7월부터 2015년 6월", 의료관련감염관리, 21(2), pp.37~49 (2016), 대한의료관련감염관리학회
  3. Allan Nkwata, "Incidence Trends of Central-Line–Associated Bloodstream Infections in Neonatal Intensive Care Units, NHSN, 2009–2018", Infection Control & Hospital Epidemiology, 41(S1), pp.s68~s68 (2020), Cambridge University Press (CUP)[DOI]
  4. F. Chaves, "Diagnosis and treatment of catheter-related bloodstream infection: Clinical guidelines of the Spanish Society of Infectious Diseases and Clinical Microbiology and (SEIMC) and the Spanish Society of Spanish Society of Intensive and Critical Care Medicine and Coronary Units (SEMICYUC)", Medicina Intensiva, 42(1), pp.5~36 (2018), Elsevier BV[DOI]
  5. Leonard A. Mermel, "The pathogenesis and epidemiology of catheter-related infection with pulmonary artery Swan-Ganz catheters: A prospective study utilizing molecular subtyping", The American Journal of Medicine, 91(3), pp.S197~S205 (1991), Elsevier BV[DOI]
  6. Leonardo Lorente, "Central venous catheter-related infection in a prospective and observational study of 2,595 catheters", Critical Care, 9(6), pp.R631~ (2005), Springer Science and Business Media LLC[DOI]
  7. "Medical privacy standard prevention guidelines" (2017)[URL]
  8. 유선미, "Interventions to Prevent Catheter-Associated Bloodstream Infections: A Multicenter Study in Korea", Infection and Chemotherapy, 42(4), pp.216~222 (2010), 대한감염학회
  9. 문형준, "응급의료센터와 중환자실에서 시행된 중심정맥카테터 감염률 비교", 대한응급의학회지, 22(6), pp.669~675 (2011), 대한응급의학회
  10. Yoo SY, "Risk factors and attributable cost of central line-associated bloodstream infection in intensive care units", pp.2009
  11. NASIA SAFDAR, "A Review of Risk Factors for Catheter-Related Bloodstream Infection Caused by Percutaneously Inserted, Noncuffed Central Venous Catheters", Medicine, 81(6), pp.466~479 (2002), Ovid Technologies (Wolters Kluwer Health)[DOI]
  12. Naomi P. O'Grady, "Guidelines for the prevention of intravascular catheter-related infections", American Journal of Infection Control, 39(4), pp.S1~S34 (2011), Elsevier BV[DOI]
  13. M. Musu, "Controlling catheter-related bloodstream infections through a multi-centre educational programme for intensive care units", Journal of Hospital Infection, 97(3), pp.275~281 (2017), Elsevier BV[DOI]
  14. R LOBO, "Impact of an educational program and policy changes on decreasing catheter-associated bloodstream infections in a medical intensive care unit in Brazil", American Journal of Infection Control, 33(2), pp.83~87 (2005), Elsevier BV[DOI]
  15. 강문희, "최대한의 멸균 차단법의 이행도와 중심정맥관 관련 혈류감염 발생에 대한 단문문자메시지 중재 효과", 간호행정학회지, 18(2), pp.244~250 (2012), 간호행정학회
  16. 임정혜, "중심정맥관 삽입시 최대멸균 차단법이 중심정맥관 관련 감염률과 비용에 미치는 효과", 성인간호학회지, 22(3), pp.229~238 (2010), 한국성인간호학회
  17. Issam I. Raad, "Prevention of Central Venous Catheter-Related Infections by Using Maximal Sterile Barrier Precautions during Insertion", Infection Control and Hospital Epidemiology, 15(4), pp.231~238 (1994), Cambridge University Press (CUP)[DOI]
  18. Kim OS, "Prevention of central venous catheter-related infections", Korean Journal of Nosocomial Infection Control, 4(1), pp.35~40 (1999)
  19. Erika M. Young, "Translating evidence into practice to prevent central venous catheter-associated bloodstream infections: A systems-based intervention", American Journal of Infection Control, 34(8), pp.503~506 (2006), Elsevier BV[DOI]
  20. Peter Pronovost, "An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU", New England Journal of Medicine, 355(26), pp.2725~2732 (2006), Massachusetts Medical Society[DOI]
  21. R. Peredo, "Reduction in catheter-related bloodstream infections in critically ill patients through a multiple system intervention", European Journal of Clinical Microbiology & Infectious Diseases, 29(9), pp.1173~1177 (2010), Springer Science and Business Media LLC[DOI]
  22. Jennifer Meddings, "Systematic Review and Meta‐Analysis: Reminder Systems to Reduce Catheter‐Associated Urinary Tract Infections and Urinary Catheter Use in Hospitalized Patients", Clinical Infectious Diseases, 51(5), pp.550~560 (2010), Oxford University Press (OUP)[DOI]
  23. Cole-Lewis H, "Text messaging as a tool for behavior change in disease prevention and management", Epidemiologic Reviews, 32(1), pp.56~69 (2010)[DOI]
  24. Lee MH, "The effect of handwashing practices improving program types in intensive care unit nurses", pp.2008
  25. Adrianne C. Feldstein, "Effect of a Multimodal Reminder Program on Repeat Mammogram Screening", American Journal of Preventive Medicine, 37(2), pp.94~101 (2009), Elsevier BV[DOI]
  26. Mark Loeb, "Stop Orders to Reduce Inappropriate Urinary Catheterization in Hospitalized Patients: A Randomized Controlled Trial", Journal of General Internal Medicine, 23(6), pp.816~820 (2008), Springer Science and Business Media LLC[DOI]
  27. Jeffrey Topal, "Prevention of Nosocomial Catheter-Associated Urinary Tract Infections Through Computerized Feedback to Physicians and a Nurse-Directed Protocol", American Journal of Medical Quality, 20(3), pp.121~126 (2016), Ovid Technologies (Wolters Kluwer Health)[DOI]
  28. Philippe Seguin, "Effectiveness of simple daily sensitization of physicians to the duration of central venous and urinary tract catheterization", Intensive Care Medicine, 36(7), pp.1202~1206 (2010), Springer Science and Business Media LLC[DOI]
  29. Comprehensive intervention to decrease central line-associated bloodstream infection in Korean ICUs, "Ministry of Health and Welfare", Korea Centers for Disease Control and Prevention, ~ (2014)
  30. Yoo JY, "Impact of maximal sterile barrier during the insertion of central venous catheters in adults intensive care units", Korean Journal of Nosocomial Infection Control, 12(1), pp.36~41 (2007)

관련 논문AI추천

이 간행물의 다른 논문 (6건)