Anucha Apisarnthanarak1, David Ratz2, M Todd Greene3, Thana Khawcharoenporn4, David J Weber5, Sanjay Saint3. 1. Department of Medicine, Thammasat University, Pathumthani, Thailand. Electronic address: anapisarn@yahoo.com. 2. Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI. 3. Center for Clinical Management Research, Veterans Affairs Ann Arbor Healthcare System, Ann Arbor, MI; Division of General Medicine, University of Michigan, Ann Arbor, MI. 4. Department of Medicine, Thammasat University, Pathumthani, Thailand. 5. Schools of Medicine and Public Health, University of North Carolina, Chapel Hill, NC.
Abstract
BACKGROUND: We evaluated the practices used in Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). METHODS: From January 1, 2014-November 30, 2014, we surveyed all Thai hospitals with an intensive care unit and at least 250 beds. The use of prevention practices for CAUTI, CLABSI, and VAP was assessed. High compliance (≥75%) with all components of the CLABSI and VAP prevention bundles were determined. CAUTI, CLABSI, and VAP infection rates before and after implementing infection control practices are reported. Multivariable regression was used to examine associations between infection prevention bundle compliance and infection rate changes. RESULTS: Out of 245 eligible hospitals, 212 (86.5%) responded. A total of 120 (56.6%) and 115 hospitals (54.2%) reported ≥75% compliance for all components of the CLABSI and VAP prevention bundles, respectively, and 91 hospitals (42.9%) reported using ≥ 4 recommended CAUTI-prevention practices. High compliance with all of the CLABSI and VAP bundle components was associated with significant infection rate reductions (CLABSI, 38.3%; P < .001; VAP, 32.0%; P < .001). Hospitals regularly using ≥ 4 CAUTI-prevention practices did not have greater reductions in CAUTI (0.02%; P = .99). CONCLUSIONS: Compliance with practices to prevent hospital infections was suboptimal. Policies and interventions promoting bundled approaches may help reduce hospital infections for Thai hospitals.
BACKGROUND: We evaluated the practices used in Thai hospitals to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), and ventilator-associated pneumonia (VAP). METHODS: From January 1, 2014-November 30, 2014, we surveyed all Thai hospitals with an intensive care unit and at least 250 beds. The use of prevention practices for CAUTI, CLABSI, and VAP was assessed. High compliance (≥75%) with all components of the CLABSI and VAP prevention bundles were determined. CAUTI, CLABSI, and VAP infection rates before and after implementing infection control practices are reported. Multivariable regression was used to examine associations between infection prevention bundle compliance and infection rate changes. RESULTS: Out of 245 eligible hospitals, 212 (86.5%) responded. A total of 120 (56.6%) and 115 hospitals (54.2%) reported ≥75% compliance for all components of the CLABSI and VAP prevention bundles, respectively, and 91 hospitals (42.9%) reported using ≥ 4 recommended CAUTI-prevention practices. High compliance with all of the CLABSI and VAP bundle components was associated with significant infection rate reductions (CLABSI, 38.3%; P < .001; VAP, 32.0%; P < .001). Hospitals regularly using ≥ 4 CAUTI-prevention practices did not have greater reductions in CAUTI (0.02%; P = .99). CONCLUSIONS: Compliance with practices to prevent hospital infections was suboptimal. Policies and interventions promoting bundled approaches may help reduce hospital infections for Thai hospitals.
Authors: La Thi Quynh Lien; Eva Johansson; Pham Thi Lan; Nguyen Thi Kim Chuc; Nguyen Thi Minh Thoa; Nguyen Quynh Hoa; Ho Dang Phuc; Ashok J Tamhankar; Cecilia Stålsby Lundborg Journal: Int J Environ Res Public Health Date: 2018-07-22 Impact factor: 3.390