Department of Clinical Microbiology and Infectious Diseases, HGU Gregorio Marañón, Madrid, Spain.
Cardiac Surgery Postoperative Care Unit, HGU Gregorio Marañón, Madrid, Spain; CIBER Enfermedades Respiratorias ‒ CIBERES (CB06/06/0058), Madrid, Spain.
J Hosp Infect. 2015 Jun;90(2):135-41. doi: 10.1016/j.jhin.2015.01.024. Epub 2015 Feb 26.
The use of intravascular catheters (IVCs) in intensive care units (ICUs) has been well assessed in recent years. However, a high proportion of these devices are placed in patients outside the ICU, particularly in internal medicine departments (IMDs), where data on the quality of care are scarce.
To assess the use and management of IVCs in IMDs in Spain.
We performed a point prevalence study of all adult inpatients on 47 IMDs from hospitals of different sizes on one day in June 2013. A local co-ordinator was appointed to assess patients and collect data from each site.
Out of the 2080 adult patients hospitalized on the study day, 1703 (81.9%) had one or more IVCs (95.4% of which were peripheral devices). Infection was detected at the insertion site in 92 catheters (5.0%); 87 patients (5.2%) had signs of sepsis, but only one case was considered to be catheter-related. The local co-ordinators estimated that 19% of the catheters in place were no longer necessary. A daily record of the need for a catheter was available in only 40.6% of cases.
Our study shows clear opportunities for improvement regarding catheter use and care in Spanish IMDs. Strategies similar to those applied in ICUs should be implemented in IMDs.
近年来,血管内导管(IVC)在重症监护病房(ICU)中的使用已得到充分评估。然而,这些设备中有很大一部分是在 ICU 之外的患者中放置的,特别是在内科病房(IMD)中,那里的护理质量数据很少。
评估西班牙 IMD 中 IVC 的使用和管理情况。
我们于 2013 年 6 月的一天对来自不同规模医院的 47 个 IMD 中的所有成年住院患者进行了一次点现患率研究。任命了一名当地协调员来评估患者并从每个站点收集数据。
在所研究的 2080 名成年住院患者中,有 1703 名(95.4%为外周设备)有一个或多个 IVC。在 92 个导管的插入部位检测到感染(5.0%);87 名患者(5.2%)出现败血症迹象,但仅一例被认为与导管有关。当地协调员估计,19%的留置导管不再需要。只有 40.6%的病例有导管需求的每日记录。
我们的研究表明,西班牙 IMD 中导管使用和护理有明显的改进空间。应在 IMD 中实施类似于 ICU 中应用的策略。