title: Open and closed models of intensive care unit have different influences on infectious complications in a tertiary care center: A retrospective data analysis.
abstract: Infectious complications in the intensive care unit (ICU) are associated with higher morbidity, mortality, and increased health care use. Here, we report the results of implementing 2 different models (open vs closed) on infectious complications in the ICU. The closed ICU model was associated with 52% reduction in ventilator-associated pneumonia rate (P = .038) and 25% reduction in central line-associated bloodstream infection rate (P = .631). We speculate that a closed ICU model allows clinical leadership centralization that further facilitates standardized care delivery that translates into fewer infectious complications.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY. Electronic address: karim.elkersh@louisville.edu.
authors.forename: Karim
authors.initials: K
authors.lastname: El-Kersh
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
authors.forename: Juan
authors.initials: J
authors.lastname: Guardiola
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
authors.forename: Rodrigo
authors.initials: R
authors.lastname: Cavallazzi
authors.affiliation: Department of Internal Medicine, Division of Infectious Diseases, University of Louisville, Louisville, KY.
authors.forename: Timothy L
authors.initials: TL
authors.lastname: Wiemken
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
authors.forename: Jesse
authors.initials: J
authors.lastname: Roman
authors.affiliation: Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
authors.forename: Mohamed
authors.initials: M
authors.lastname: Saad
mesh_terms: D055499:Catheter-Related Infections / Q000453:epidemiology*; D003422:Critical Care / Q000379:methods*; D007362:Intensive Care Units; D053717:Pneumonia, Ventilator-Associated / Q000453:epidemiology*; D015995:Prevalence; D012189:Retrospective Studies; D062606:Tertiary Care Centers
keywords: CLABSI; Infection; VAP