Several descriptive, bivariate, and multiple statistical methods were applied to study the association of BV with CT or NG infection in the study population. Descriptive tables were generate to show the frequency and percentage of cases and controls for each study variable. For categorical variables, cases and controls were compared using the Mantel-Haenszel-Cochran chi-square test, a repeated test of independence (Mantel and Haenszel, 1959). Crude (unadjusted) and adjusted matched odds ratios (O-R) were calculated to quantify the statistical association between BV and CT or NG infection. OR also called the cross-product ratio is the ratio of two odds (Szumilas, 2010). An OR of one indicates that the odds of exposure (BV) is similar in …show more content…
Therefore, the presence of effect modifiers of BV on CT or NG on the additive scale was evaluated using two epidemiological indexes: the synergy or positive interaction and the relative excess risk due to interaction or simply RERI. Synergy equal to one and RERI equal to zero indicate there is no departure from additivity. As a result the total effect of two risk factors together is not greater than the sum of these risk factors taken independently (de Mutsert et al., 2009). To determine whether an independent study variable does not bias the effect of BV on CT or NG infection, the presence and magnitude of confounding was evaluated. In epidemiology, a confounder must be associated with the outcome, must has an independent association with the exposure, and must not be an intermediate step in the causal pathway between exposure and disease (Mcnamee, 2003). In this study, an independent variable was considered confounder whether it meets the previous criteria and the degree of discrepancy between unadjusted and adjusted odds ratios was by more 10 percent. All reported p-values were two-sided and < 0.05 were considered statistically significant. Data analyses were carried out using Stata version 13 (Stata Corporation, College Station, Texas,
Fowler and colleagues, using the STS ACSD, reported a rate of 3.51% for major infections, defined as any one of the following: mediastinitis, thoracotomy or vein harvest site infection, or septicemia.4 Shih reported a HAI rate of 5.1% among patients undergoing CABG surgery at any of 33 hospitals in the state of Michigan.1 Shih used STS ACSD data, similar to Fowler, although included pneumonia and sepsis to define HAIs. Similar to our present study, pneumonia was the most common type of HAI, occurring among 3.1% of patients.
PICC-related bloodstream infections were found less frequently in patients with the antimicrobial PICC. The nonintervention group had a total of 8 CLABSIs (rate ¼ 4.18/1,000 catheter days). There was 1 CLABSI (rate ¼ 0.47/1,000 catheter days) in the intervention group. Along the course of the study there were limitations affecting its applicability. For example, the 2 study groups were not fully comparable with respect to underlying conditions or admitting diagnosis that might have predisposed the patients to CLABSI. The variables collected on each diagnosis varied greatly between patients and did not offer a pattern to code effectively for known CLABSI risk factors. The quasiexperimental design could only provide evidence of probability. The retrospective data for the nonintervention group was another limitation. In addition, the inability of the researcher to determine the significance of nursing compliance with maintenance practices could have introduced bias into this
Individuals with cancer are predisposed to infection and are at a greatly increased risk for death from infection-related illnesses. In addition to the immunosuppressive effects of the cancer itself, individuals with cancer may be at increase risk for infection due to surgery and treatments such as chemotherapy and radiation. Frequent hospital stays and devices such as indwelling catheters
As a nurse in the critical care unit I noticed an increase in CAUTIs over the last six months furthermore, there was also an increase in new clinical staff during that time. Using my skills learned in my Evidence Based Practice course I investigative the increase in CAUTIs on the unit. The patients in the ICU are at risk for CAUTIs because they are catheterized for an extended period of time, which is the single greatest risk factor for CAUTIs. Additionally, ICU patients are sicker than in the past which has increased length of stay. Additionally, this has also compromised their immune system, making them more susceptible to infection.
Peripherally inserted central catheters (PICCs) can be used for routine patient care for treatment and have been increasingly used over the past years. They are more invasive than a peripheral intravenous line (PIV); however, they can be inserted at the bedside, are easily removed, and provide many positive benefits. PICCs relieve patients from frequent venipuncture for serial lab draws, decreases frequent re-starts of PIVs, and the patient can be discharged home, if needed, for continued IV therapy. Although there are benefits to these easily inserted central lines, central line-associated bloodstream infections (CLABSI) are a possibility (Dumont & Nessselrodt, 2012).
The majority of the studies collected retrospective data via a reporting system from Emergency Departments (EDs) in the US and Canada. This does not account for the number of TBIs which are treated in general practice or clinic settings or by EDs which do not use those specific reporting systems. There is also the ongoing issue of underreporting which, while being well-known, is nearly impossible to fully account for.
As mentioned above, there are a multitude of practices that are practice to decrease the prevalence of central line associated blood stream infections. To prevent central line associated bloodstream infections there are several steps before and during the insertion process as well as after the insertion of the line to decrease the risk of developing an infection. To begin with, it is important to avoid using the femoral vein for central venous catheter insertion is possible (Hsu, 2014). Avoiding the femoral vein is important because it is consider a dirty area of the body; therefore, the preferred site for the insertion of these lines is the subclavian vein because it is considered the area that is least likely to be infected. Furthermore,
The CDC’s National Healthcare Safety Network (NHSN) supports 2,000 hospitals nationally (Central line-associated bloodstream infections, n.d.). Since March 2010, hospitals, in twenty one of the United States’ fifty states, are required to report their hospital acquired infections to the NHSN (Central line-associated bloodstream infections, n.d.). The CMS data report includes identification numbers for the hospitals the CLABSI happened at, the name and address of the hospitals, the number days the central line was in, the number of CLABSI incidences the hospitals had, and each hospitals’ National Healthcare Safety Network standardized infection ratio (SIR) (Tabak et al.,
As nurses it is our job to know these factors that can increase patients vulnerability to infections, such as drug therapy, certain diseases, and if a patient is going under surgery. This allow the nurse to be vigilant on which patients is at risk in other
The aim of the study is to “investigate whether rates of community- and healthcare-associated bloodstream and surgical site infections varied by patient gender in a large cohort after controlling a wide variety of possible confounders” (Cohen et al., 2013).
Risk for impaired tissue integrity related to irritation of the skin secondary to incontinent diarrhea
A problem identified in my clinical experience at the Veterans Administration Medical Center was improper infection control measures when a patient was on isolation precautions. HAIs are something that can be prevented but are still very prevalent today. They increase rates of increase hospital stays, cost, readmission, morbidity, and death. The Center for Disease Control notes, “HAIs affect 5 to 10 percent of hospitalized patients in the U.S. per year. Approximately 1.7 million HAIs occur in U.S. hospitals each year, resulting in 99,000 deaths and an estimated $20 billion in healthcare costs.” (CDC, 2015) HAIs can come from cross contamination from healthcare workers to the patients, patients to other patient’s, family members to patients,
By definition pneumonia is a serious lung infection that can cause difficulty with breathing, coughing, fever and fatigue. In the elderly and the very young it can lead to death. The Join Commission estimates that 125,000 people are hospitalized each year due to pneumococcal pneumonia (2015). Due to the mortality rates of this disease the Joint Commission (JC) has developed a set of core measures that provide a guideline for hospitals with suspected cases of pneumonia. The Joint commission focuses the set of core measures on the problems of the initial treatment of the disease and how the patient is taught to prevent future episodes.
Annually, in developing countries more than 10% of hospitalized patients acquired the infection. The World Health Organisation (2009) pointed to recent studies carried out in Tunisia, Albania, Morocco, and the United Republic of Tanzania. They used a day prevalence survey to assess the Hospital acquired infection (HAI). The prevalence rate of HAI varied between 19.1% and 14.8%. The HAI burden is more serious and dangerous in high risk population such as neonates and adults accommodated in the Intensive care unit (ICU) (WHO, 2009).
Study of Mortality, Morbidity and Cost attributable to Health Care-Associated Infection in a Tertiary Level Healthcare Institution