Clinical effectiveness of evidence-based strategies combined with predictive management for the prevention and control of multi-drug resistant organism infections in the ICU
OBJECTIVE To investigate the clinical effectiveness of"evidence-based strategies combined with predic-tive management"(EBSCPM)for the prevention of multi-drug resistant organism(MDRO)infections in intensive care unit(ICU)patients.METHODS 687 patients admitted to the ICU of Ningbo No.2 Hospital from Jun.2016 to May 2018 were selected as the control group,and 1 576 patients admitted from Jun.2019 to May 2021 were se-lected as the intervention group,in which the control group received conventional MDRO infection prevention and control measures,and the intervention group underwent the EBSCPM on this basis.EBSCPM included ICU ward partitioning,environmental MDRO monitoring,skin cleansing with 2％chlorhexidine wipes,ward disinfection with hydrogen peroxide spray,stringent hand hygiene inspection,"critical"notation for MDRO detection,and e-lectronic display of infection control information.The rates of MDRO and nosocomial infections,implementation of prevention and control measures,and detection rates of environmental MDRO were compared between the two groups.RESULTS The rates of MDRO infection,nosocomial infection and environmental MDRO detection in in-tervention group were lower than those in control group(all P＜0.05).The rate of implementation of contact iso-lation measures,the time to implement contact isolation,hand hygiene compliance and accuracy were significantly improved in the intervention group(all P＜0.05).Multivariate analysis showed that EBSCPM was associated with lower rates of nosocomial infection and MDRO infection in ICU patients(nosocomial infections:OR=0.44,95％CI:0.35-0.55,P＜0.001;MDRO infections:OR=0.35,95％CI:0.27-0.44,P＜0.001).CONCLUSION Ap-plication of EBSCPM was associated with improved prevention and control of nosocomial and MDRO infections in ICU patients.
Evidence-based strategyPredictive managementIntensive care unitMulti-drug-resistant organismPrevention and contorl of nosocomial infection
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