title: External ventricular drain infection: the effect of a strict protocol on infection rates and a review of the literature.
abstract: External ventricular drains (EVDs), like any surgically-implanted foreign body, are at risk of infection. We present the results of a completed audit loop following introduction of an evidence-based protocol for their insertion and management. There were two phases over a 2-year period. Phase 1 was a retrospective audit of our EVD infection rate. Phase 2 was a prospective audit of the infection rate subsequent to the introduction of a protocol for the insertion and management of EVDs. In phase 1, the infection rate was 27%. In phase 2, the infection rate was 12%. This was a statistically significant reduction (p < 0.05, Chi-squared test). EVD infection is unfortunately a common clinical problem and associated with potential morbidity and mortality. This study demonstrates that adherence to an evidence-based protocol for their insertion and management is associated with a significant reduction in the infection rate.
authors.affiliation: Department of Neurological Surgery, Radcliffe Infirmary, Oxford, UK.
authors.forename: D
authors.initials: D
authors.lastname: Dasic
authors.forename: S J
authors.initials: SJ
authors.lastname: Hanna
authors.forename: S
authors.initials: S
authors.lastname: Bojanic
authors.forename: R S C
authors.initials: RS
authors.lastname: Kerr
mesh_terms: D002408:Catheters, Indwelling / Q000009:adverse effects*; D020806:Central Nervous System Bacterial Infections / Q000209:etiology / Q000517:prevention & control*; D002552:Cerebral Ventricles / Q000601:surgery; D002557:Cerebrospinal Fluid Shunts / Q000009:adverse effects; D002985:Clinical Protocols / Q000592:standards*; D004322:Drainage / Q000009:adverse effects / Q000592:standards*; D004660:Encephalitis / Q000209:etiology / Q000517:prevention & control; D019317:Evidence-Based Medicine / Q000592:standards; D005260:Female; D006801:Humans; D007427:Intracranial Pressure; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000009:adverse effects; D011446:Prospective Studies; D012189:Retrospective Studies