Effectiveness of a multimodal strategy to reduce external ventricular drain–associated infection: A quasi-experimental study
Issued Date
2024-01-01
Resource Type
ISSN
01966553
eISSN
15273296
Scopus ID
2-s2.0-85198549375
Pubmed ID
38969072
Journal Title
American Journal of Infection Control
Rights Holder(s)
SCOPUS
Bibliographic Citation
American Journal of Infection Control (2024)
Suggested Citation
Pongkaew C., Noiphithak R., Rukskul P., Yodwisithsak P., Tantongtip D., Nimmannitya P., Punyarat P., Duangprasert G., Kaewwichai W., Songphul S., Chancharoenrat W., Jantarathaneewat K., Chokaouychai C., Sukhor S., Apisarnthanarak P., Camins B.C., Weber D.J., Apisarnthanarak A. Effectiveness of a multimodal strategy to reduce external ventricular drain–associated infection: A quasi-experimental study. American Journal of Infection Control (2024). doi:10.1016/j.ajic.2024.06.026 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/99744
Title
Effectiveness of a multimodal strategy to reduce external ventricular drain–associated infection: A quasi-experimental study
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Infection is a serious complication in neurosurgical patients who undergo external ventricular drain (EVD) insertion. Methods: We conducted a quasi-experimental study in patients who underwent EVD insertion to evaluate the impact of a multi-modal strategy to reduce the incidence of external ventricular drain associated infections (EVDAIs). The study was divided into 2 periods; (1) the pre-intervention period when techniques for EVD insertion and maintenance were up to the discretion of the neurosurgeons and (2) the post-intervention after implementation of a multi-modal strategy (cefazolin antibiotic prophylaxis, preoperative chlorhexidine showers, application of postoperative chlorhexidine-impregnated dressing, limited manipulation of the EVD, and meticulous EVD management). The primary outcome was the incidence rate of EVDAIs; secondary outcomes included in-hospital mortality rate, the hospital length of stay. Results: In total, 135 patients were included. The incidence rate of EVDAIs was significantly reduced in the post-intervention period (5.6 cases/1,000 EVD-days) compared with the pre-intervention period (18.2 cases/1,000 EVD-days; P=0.026). There were no differences in all secondary outcomes analyzed. This multi-modal strategy was associated with high satisfaction among health care personnel. Conclusions: Implementation of a multi-modal strategy was associated with a reduction in the incidence of EVDAIs. This was in line with our goal of promoting a new culture of safety despite being in a resource-limited setting.