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Objective: The aim of this study was to analyze the impact of process and outcome surveillance on rates of device-associated health care-associated infections (DA-HAI) in an intensive care unit (ICU) in Turkey over a four-year period. Material and Methods: An open label, prospective cohort, active DA-HAI surveillance study was conducted on 685 patients admitted to the ICU of a university hospital in Turkey from January 2004 to December 2007, implementing the methodology developed by the International Nosocomial Infection Control Consortium. DA-HAI rates were recorded according to Centers for Disease Control and Prevention (CDC), National Healthcare Safety Network (NHSN) definitions. We analyzed the rates of DA-HAI, mechanical ventilator-associated pneumonia (VAP), central line-associated bloodstream infection (CLA-BSI), and catheter-associated urinary tract infection (CAUTI), as well as microorganism profile, extra length of stay, and hand hygiene compliance. Pooled DA-HAI rates were calculated and compared by year. Results: The DA-HAI rate per 100 patients declined as follows: for 2004, the DA-HAI rate was 58.4%; for 2005, it was 38.9%; for 2006, it was 34.8%; and for 2007, it was 10.9%. The DA-HAI rate per 1,000 bed-days also declined: for 2004, it was 42.8, and for 2007 it was 10.7. The rates decreased from 25.8 to 13.4 for VAP; from 29.9 to 25.0 for CLA-BSI; and from 9.2 to 6.2 for CAUTI cases per 1,000 device-days during the study period. Conclusion: Process and outcome surveillance of DA-HAI significantly reduced DA-HAI. Turkish Baslik: Bir Turk Yogun Bakim Unitesinde Egitim ve Surveyansin Alet Iliskili Hastane Enfeksiyon Hizlari Uzerine Etkisi: Uluslar Arasi Nozokomiyal Enfeksiyon Kontrol Konsorsiyum Verileri Anahtar Kelimeler: Hastane enfeksiyonlari, ventilator iliskili pnomoni, santral kateter iliskili kan dolasimi enfeksiyonu, kateter iliskili idrar yolu enfeksiyonu, surveyans, el hijyeni, yogun bakim unitesi Amac: Bu calismanin amaci, Turkiye'deki bir yogun bakim unitesinin dort yillik egitim ve surveyansinin alet iliskili hastane enfeksiyon hizlari uzerine etkisinin degerlendirilmesidir. Gerec ve Yontem: Calisma prospektif kohort, acik-etiketli, aktif, alet iliskili hastane enfeksiyon takibi ile, Turkiye'deki bir universite hastanesinin yogun bakim unitesinde Ocak 2004 ve Aralik 2007 tarihleri arasinda kabul edilen 685 hastada uluslar arasi nozokomiyal enfeksiyon kontrol konsorsiyumunun gelistirdigi yontemlerin uygulandigi bir calismadir. Alet iliskili hastane enfeksiyon hizlari “Amerikan Hastalik Kontrol ve Onleme Merkezleri (CDC)” ve “Ulusal Saglik Hizmeti Guvenlik Calisma Agi (NHSN)” tanimlarina gore kayit edildi. Alet iliskili enfeksiyon hizlari, ventilator iliskili pnomoni hizlari, santral kateter iliskili kan dolasimi enfeksiyon hizlari, kateter iliskili idrar yolu enfeksiyon hizlari, mikroorganizma profilleri, ekstra hastane kalis gunleri ve el hijyeni uyumlari analiz edildi. Alet iliskili enfeksiyon hizlari hesaplandi ve yillara gore karsilastirildi. Bulgular: Yuz hasta basina dusen alet iliskili hastane enfeksiyon hizlari 2004 icin %58.4, 2005 icin %38.9, 2006 icin %34.8 ve 2007 icin %10.9 olarak izlenmistir. Buna ek olarak 1000 hastane gunu basina dusen alet iliskili hastane enfeksiyon hizlari da 2004 icin 42.8, 2007 icin 10.7'dir. Ventilator iliskili pnomoni hizlari 25.8'den 13.4'e, santral kateter iliskili kan kulturu enfeksiyon hizlari 29.9'dan 25.0'a, kateter iliskili idrar yolu enfeksiyon hizlari ise 9.2'den 6.2'ye gerilemistir. Sonuc: Alet iliskili hastane enfeksiyonlarinin surveyansi, bu enfeksiyonlari belirgin sekilde azaltmistir.

balkan medical journal/balkan medical journal

Impact of Education and Process Surveillance on Device-Associated Health Care-Associated Infection Rates in a Turkish ICU: Findings of the International Nosocomial Infection Control Consortium (INICC)