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  • 1
    ISSN: 1432-055X
    Keywords: Schlüsselwörter Intensivmedizin ; Surveillance ; Infektionsraten ; Prävention ; Qualitätsmanagement ; Keywords Intensive care ; Surveillance ; Prevention ; Quality management ; Infection rates
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Abstract Objectives. To establish a surveillance system as an element of internal quality management, participating intensive care units (ICUs) report their ICU-associated infection surveillance data for aggregation into a national database. Methods. In order to provide data on ICU-associated infections, a nosocomial surveillance system in German intensive care units (Krankenhaus-Infektions-Surveillance-System (KISS)) started in 1997. The method of data collection is based on the (adult) ICU surveillance component from the National Nosocomial Infections Surveillance (NNIS)-System. Until now 113 German ICUs (most of them medical/surgical ICUs) were included in this system. We continuously collected and calculated the data from site-specific infections (device-associated pneumonias, blood stream infections and urinary tract infections). Results. There are now a total of 393.177 patient-days (100.015 patients) among them 176.415 ventilator-days, 295.221 central line-days and 316.799 urinary catheter-days in the data base. The data analysis showed the following device-associated infection rates: 11.2 pneumonias/1000 ventilator-days, 1.8 primary bloodstream infections/ 1000 central line-days and 4.0 urinary tract infections/1000 urinary catheter-days. Conclusion. The project has reached high interest in Germany and animated more ICUs to take part or to apply the same method in order to use the reference data for comparison.
    Notes: Zusammenfassung Die fortlaufende, systematische Erfassung, Analyse und Interpretation (=Surveillance) nosokomialer Infektionsraten spielt die wesentliche Rolle bei der Problemidentifikation und der nachfolgenden Problemlösung im Rahmen der Infektionsprävention. Ziel des Nationalen Referenzzentrums für Krankenhaushygiene und des Robert Koch-Instituts war die Etablierung einer einheitlichen Surveillance-Methode auf mehreren Intensivstationen und die Bereitstellung der gewonnenen Daten als nationale Referenzdaten. Seit Januar 1997 wird für Deutschland eine Referenzdatenbank zur Surveillance nosokomialer Infektionen auf Intensivstationen aufgebaut. Auf 113 Intensivstationen wurden bisher die Daten von 100.015 Patienten (393.177 Patiententage) erfasst. Als Methode der Standardisierung wird die Anzahl der Infektionen, die während der Anwendung eines Risikofaktors auftreten (Harnwegskatheter, ZVK oder maschinelle Beatmung) auf die Anwendungshäufigkeit des Risikofaktors bezogen (“device”-assoziierte Infektionsrate). Folgende “device”-assoziierten Infektionsraten wurden ermittelt: 4, 0 Harnwegsinfektionen/1.000 Harnwegskathetertage, 1, 8 primäre Septikämien/1000 ZVK-Tage und 11, 2 Pneumonien/1.000 Beatmungstage (Mittelwerte). Durch den Vergleich der eigenen Daten mit denen der Referenzdatenbank haben Intensivstationen Gelegenheit, Anhaltspunkte für eine Optimierung von Präventionsmaßnahmen zu erhalten.
    Type of Medium: Electronic Resource
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  • 2
    ISSN: 1439-0973
    Keywords: Key Words Nosocomial infections ; Intensive care units ; Benchmarking ; Quality management ; Surveillance
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Background: The objectives of this study were to determine to what extent the German national nosocomial infection surveillance system (Krankenhaus Infektions Surveillance System, KISS) can take into account the circumstances prevailing in various intensive care units (ICUs) and to establish whether KISS-ICU infection rates can serve as useful benchmark parameters. Methods: The investigation focused on three major factors: microbiological monitoring, severity of illness and the duration of surveillance. For each of these factors separate infection rates were calculated for various ICU groups and the differences compared. Results:Significant differences were found for catheter-associated urinary tract infections (CAUTI) with routine monitoring, but not for ventilator-associated pneumonia (VAP). Significant differences were assessed for central venous catheter-associated bloodstream infections (CVC-BSI), considering the average ventilator utilization rate in the ICU as a surrogate parameter for the average severity of illness in its patient group. Surveillance periods of about 1 year were necessary to confirm definite outlier and nonoutlier positions for the majority of the ICUs. Conclusion: Using KISS data for internal orientation, it is possible to note important differences between ICUs when interpreting infection rates; some initial examples of successful use of surveillance data for the reduction of infection rates are already available. However, the use of such data for external assessment is not possible, because external observers are often unable to fully consider important factors in the interpretation of infection rates.
    Type of Medium: Electronic Resource
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