[ Contact isolation and prevention of spreading of serious infections in an intensive care unit. Description of a protocol].
Hospital infection (HI) represents a serious care problem in critical patients. The presence of this complication is associated to an increase in the baseline seriousness of the patient, that is translated into greater care effort, multiplication of workload and greater mortality. This situation is clearly complicated when the causal agent of the infection is a multiresistant bacteria, since it also requires specific measures aimed at avoiding crossed transmission of the infection to other patients in addition to route treatment. The objective of the Nursing Note is to communicate our routine action in the face of this problem. From January 2003 to December 2004, 2420 patients were admitted to our Department. Of these 190 had some ICU hospital acquired infection (8.48%). Isolation steps were begun in 112 patients (4.62%) and also preventive measures as they were immunodepressed patients (inverse isolation) or patients at risk of presenting colonization or infection by multiresistant germs (preventive isolation) or due to suffering a demonstrated infection by said microorganisms. The mean seriousness, measured by the Simplified Acute Physiology Score (SAPS II), of the sample was 30+/-16 points. Those infected had a mean seriousness of 44+/-15 points and those isolated 49+/-19 points. Nursing workloads, measured by Nine Equivalents of Nursing Manpower Use Score (NEMST) were 150+/-274 points for all the sample, while the infected patients had 737+/-460 and the isolated ones 811+/-452 points. Global mortality in said period was 12.6%, while those infected had a mortality of 32% and the isolated ones 43%. The average costs per stay were 5069 euro. Patients who suffered any infection during their stay in the ICU increased their stay cost up to 26,630 euro and those isolated up to 29,050 euro. Faced with this situation, it was decided to stress the Contact Isolation procedures to achieve correct fulfillment of the preventive measures and achieve reduction in the hospital infection rates and crossed transmission between patients by multiresistant pathogens.
Morán Marmaneu
Marian
M
Diplomadas en Enfermería, Servicio de Medicina Intensiva, Hospital Universitario Asociado General de Castellón, Castellón, España.
Tejedor López
Rosa
R
Sanchís Muñoz
Josefa
J
Reig Valero
Roberto
R
Abizanda Campos
Ricardo
R
Bernat Adell
Amparo
A
D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003428:Cross Infection / Q000188:drug therapy / Q000517:prevention & control*; D005260:Female; D006801:Humans; D017053:Infection Control / Q000191:economics / Q000379:methods*; D007362:Intensive Care Units / Q000191:economics / Q000592:standards / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D010356:Patient Isolation
D000900:Anti-Bacterial Agents