Intensive Care Unit as an indicator

Author : Vinod Raghava, Nandita Hazra, Nikhat Jahan, Mukul Bajpai, Pratap Shankar, Rakesh Kumar Dixit

Introduction: The Hospital Infection Control Committee has an arduous role in a tertiary care hospital where lapses in infection control measures can adversely impact patient morbidity and survival. Outbreaks of epidemiologically important Gram negative and Gram positive pathogens can further worsen the scenario due to development of multiple drug resistant strains. WHONET, available on the web, is a freely, downloadable software can be used to monitor the impact of hospital infection control measures with the intensive care unit as an indicator. Objective: To assess the impact of Hospital Infection Control Committee (especially the activities of the Infection Control Team) on infection control measures in an intensive care unit on the isolation of Gram-negative and Gram-positive pathogens by the use of WHONET. Methods: Hospital infection surveillance using the WHONET data collection tool is a routine activity in our 780-bed teaching tertiary health care hospital in Lucknow. From Nov 2015 through Dec 2015, interventional and educational activities were reinitiated for health care workers (HCWs). The education included lectures to residents, medical officers and nursing and paramedical staff on best practices in Infection control and how hand washing could impact infection control. Organism surveillance ICU data from pre-intervention (Jan-Dec 2015) and post- intervention (Jan-Mar 2016) were imported from the surveillance system and statistically analyzed. Results: During the period from January 2015 to December 2015, a total of 1014 patients were admitted to the intensive care unit (ICU), which includes Medical, Surgical and Step-down units of the hospital. The activities initiated by the members of the HICC resulted in an overall reduction in the Gram-positive and Gram-negative isolation rates from the ICU. Conclusion: With the widespread dissemination of multidrug-resistant (MDR) bacteria globally there is a renewed need for a relook at the role of the HICC. A multipronged approach along of the ICT works well to optimize the management of patients infected or colonized with these bacteria.

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