The impact of interventions to improve adherence to preventive measures on the incidence of nosocomial infections in ICUs

Sa？etak Half of all life-threating nosocomial infections occur in intensive care units (ICUs) and, despite the advances in intensive care, the incidence of nosocomial infections is still high. About one third of nosocomial infections are considered preventable. Awareness of risk factors, adherence to preventive measures and collaboration of all members participating in preventive programmes can lead to reduction of the incidence of nosocomial infections and thus can produce a positive impact on reducing morbidity, mortality and healthcare costs. A retrospective surveillance study was performed in a 14-bed medical ICU to identify device-related infections before and after the preventive interventions. Ventilator-associated pneumonia (VAP), central line-associated bloodstream infections (CLABSI) and catheter-associated urinary tract infections (CAUTI) were obtained and compared before and after the interventions. In the year before the interventions, device-related nosocomial infections were diagnosed in 7.9% out of 737 hospitalised patients in the ICU, and in the year after the interventions they were diagnosed in 5.1% out of 684 hospitalised patients. Before the interventions, the infection rates were distributed as follows: 7.5 CLABSI/1000 catheter days, 28.4 VAP/1000 ventilator days, 6.5 CAUTI/1000 catheterisation days. After the interventions, the rates were distributed as follows: 2.5 CLABSI/1000 catheter days, 26.5 VAP/1000 ventilator days and 4.1 CAUTI/1000 catheterisation days. The implementation of effective preventive measures and maintaining strict surveillance is the basis of limiting the risk of nosocomial infections. Since hospital nosocomial infection rate is considered an indicator of quality and safety of care, all infection control activities are focused to decrease rate of nosocomial infections