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  1. Decreasing catheter-related infection and hospital costs by continuous quality improvement.

    Article - En anglais

    Objectives 

    A) To reduce the rate of catheter-related infection, using improved skin preparation and catheters impregnated with silver sulfadiazine and chlorhexidine ; b) to decrease the number of unnecessary guidewire exchanges of existing catheters by substituting suspected catheter-related sepsis for fever alone as an indication to change an indwelling catheter ; and c) to decrease the hospital costs associated with guidewire exchanges and new catheter insertions.

    Design 

    Sequential, prospective, descriptive studies using a continuous quality management approach.

    Setting 

    A 20-bed trauma intensive care unit at a university teaching hospital.

    Patients 

    Patients (n=147) admitted from July 1 to December 31,1992 (phase 1) ; 34 patients admitted in June and September 1993 (phase 2) ; and 156 patients admitted between January 1 and June 30,1994 (phase 3).

    Interventions 

    Phase 1 : Proportions of catheter-related infections and catheter-related bacteremia were compared with our prior reported results.

    Indications for guidewire exchange were analyzed, and the rate of catheter-related infection for each indication was derived.

    Phase 2 : The rate of catheter-related infection was determined for a trial group of triple-lumen catheters Impregnated with silver sulfadiazine and chlorhexidine.

    Phase 3 : Four components were altered.

    Impregnated triple-lumen catheters were used instead of unprotected catheters. (...)

    Mots-clés Pascal : Cathétérisme, Veine centrale, Infection nosocomiale, Complication, Hospitalisation, Cathéter, Sulfadiazine, Chlorhexidine, Qualité, Coût, Prévention, Résultat, Homme, Soin intensif, Antiseptique, Désinfectant, Antiinfectieux, Sulfamides, Economie santé

    Mots-clés Pascal anglais : Catheterization, Central vein, Nosocomial infection, Complication, Hospitalization, Catheter, Sulfadiazine, Chlorhexidine, Quality, Costs, Prevention, Result, Human, Intensive care, Antiseptic, Disinfecting agent, Antiinfectious, Sulfanilamide derivatives, Health economy

    Logo du centre Notice produite par :
    Inist-CNRS - Institut de l'Information Scientifique et Technique

    Cote : 97-0003471

    Code Inist : 002B27B14B. Création : 21/05/1997.