Korean J Nosocomial Infect Control.  2002 Jun;7(1):13-24.

Effects of Improved Methods of Endotracheal suction and Hand Washing on Incidence of Nosocomial Pneumonia in the Neurosurgical Intensive Care Unit

• Kim SY
• Lee JY
• Choi KO
• Kim YR
• Kang MW

Abstract

BACKGROUND: This study aimed at identifying the effects of improved methods of endotracheal suction and hand washing on incidence of nosocomial pneumonia (NP) in the neurosurgical ICU. METHOD: Repeated training of nurses about hand washing and adherence of the single use of suction catheter and sterile normal saline of endotracheal suction was provided. Then hand washing compliance of nurses before and after training was investigated. and the incidence of NP in all patients hospitalized for more than 72 hours in the neurosurgical ICU was investigated from Sep 1, 2000 to Jan 31, 2001 (2nd surveillance). The NP rate of that period was compared with the incidence of the 1st surveillance period, from Sep 1, 1999 to Jan 31, 2000. The data were analyzed with chi-square-test. Fisher's exact test and logistic regression analysis by SAS 8.0. RESULT: The proportion of hand washing performance increased from 15.6% to 46.8%. The rates of NP per patient during 1st surveillance and 2nd surveillance were 10.3%, 3.9%(p=0.01) patient-days rates of NP were 10.0 cases/1,000 patient days, 4.1 cases/1,000 patient days(p=0.04), and ventilator-days rates of NP were 67.6 cases/1.000 ventilator days, 16.2 cases/1,000 ventilator days(p=0.00) respectively. Out of 29 isolates, 18 were methicillin-resistant Staphylococcus aureus, which was the most frequently isolated microorganism. The risk factors associated with incidence of NP were age, length of stay, Glasgow coma scale, diabetes mellitus, duration of intubation, insertion of endotracheal tube, duration of tracheostomy, presence of tracheostomy, duration of ventilator, use of ventilator, and insertion of nasogastric tube.
CONCLUSION
These results showed that single use of suction catheters and sterile normal saline and increased compliance of hand washing were important factors to decrease the incidence of NP.

Keyword

Nosocomial pneumonia (NP); Hand washing; Endotracheal suction

MeSH Terms

Catheters
Compliance
Diabetes Mellitus
Glasgow Coma Scale
Hand Disinfection*
Hand*
Humans
Incidence*
Intensive Care Units*
Critical Care*
Intubation
Length of Stay
Logistic Models
Methicillin-Resistant Staphylococcus aureus
Pneumonia*
Risk Factors
Suction*
Tracheostomy
Ventilators, Mechanical