1Radboud Institute for Health Sciences, IQ healthcare, Radboud University Medical Center, PO box 9101 (114), 6500 HB Nijmegen, The Netherlands.
2Erasmus MC, University Medical Center Rotterdam, PO box 2040, 3000 CA Rotterdam, The Netherlands.
Antimicrob Resist Infect Control. 2020 Jan 6;9(1):7. doi: 10.1186/s13756-019-0667-3. eCollection 2020.
To examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and infection (CDI).
Between 18 July 2017 and 31 October 2017, we surveyed the infection prevention teams of all acute care hospitals in the Netherlands. The survey instrument was based on the 'Translating Healthcare-Associated Infection Prevention Research into Practice' (TRIP) questionnaire and adapted to the Dutch context. Descriptive statistics were used to examine the reported regular use of CAUTI, CLABSI, VAP, and CDI prevention practices as well as the hospital characteristics.
Out of 72 eligible hospitals, 47 (65.3%) responded. Surveillance systems for monitoring CAUTI, CLABSI, VAP, and CDI were present in 17.8, 95.4, 26.2, and 77.3% of hospitals, respectively. Antimicrobial stewardship programs have been established in 91.5% of participating hospitals. For CAUTI, the majority of hospitals regularly used aseptic technique during catheter insertion (95%) and portable bladder ultrasound scanners (86.1%). Intermittent catheterization and catheter stop-orders were regularly used by 65.8 and 62.2% of hospitals. For CLABSI, all hospitals regularly used maximum sterile barrier precautions and chlorhexidine gluconate for insertion site antisepsis. Avoidance of the femoral site for central line insertions was regularly used by 65.9% of hospitals. Urinary catheters and central-lines impregnated with antibiotics or antiseptics were rarely used (≤ 5%). Selective decontamination strategies for preventing VAP were used in 84% of hospitals. With the exception of disposable thermometers (31.8%), all prevention practices to prevent CDI were regularly used by more than 80% of hospitals.
Most Dutch hospitals report regular use of recommended practices for preventing CLABSI and CDI. Several specific practices to prevent CAUTI and VAP were less frequently used, however, providing an opportunity for improvement.
研究荷兰的急症护理医院在多大程度上采用了预防导管相关尿路感染（CAUTI）、中心静脉导管相关血流感染（CLABSI）、呼吸机相关性肺炎（VAP）和艰难梭菌感染（CDI）的推荐实践。
在 2017 年 7 月 18 日至 10 月 31 日期间，我们调查了荷兰所有急症护理医院的感染预防团队。调查工具基于“将医疗保健相关感染预防研究转化为实践”（TRIP）问卷，并根据荷兰的情况进行了调整。采用描述性统计方法检查了报告的 CAUTI、CLABSI、VAP 和 CDI 预防实践的常规使用情况以及医院特征。
在 72 家符合条件的医院中，有 47 家（65.3%）做出了回应。分别有 17.8%、95.4%、26.2%和 77.3%的医院存在监测 CAUTI、CLABSI、VAP 和 CDI 的监测系统。参与医院中有 91.5%建立了抗菌药物管理计划。对于 CAUTI，大多数医院在导管插入时经常使用无菌技术（95%）和便携式膀胱超声扫描仪（86.1%）。间歇性导尿和导管停止医嘱分别由 65.8%和 62.2%的医院定期使用。对于 CLABSI，所有医院都经常使用最大无菌屏障预防措施和葡萄糖酸洗必泰进行插入部位消毒。65.9%的医院经常避免在股部进行中心静脉插入。很少使用抗生素或防腐剂浸渍的导尿管和中心静脉导管（≤5%）。预防 VAP 的选择性去污染策略在 84%的医院中使用。除了一次性温度计（31.8%）外，预防 CDI 的所有预防实践都有超过 80%的医院定期使用。
大多数荷兰医院报告经常使用预防 CLABSI 和 CDI 的推荐实践。然而，一些预防 CAUTI 和 VAP 的特定实践使用频率较低，因此有改进的机会。
