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Infection prevention practices in the Netherlands: results from a National Survey.
Antimicrobial Resistance & Infection Control ( IF 4.8 ) Pub Date : 2020-01-06 , DOI: 10.1186/s13756-019-0667-3
Anita Huis 1 , Jeroen Schouten 1 , Dominique Lescure 2 , Sarah Krein 3, 4, 5 , David Ratz 3, 5 , Sanjay Saint 3, 4, 5 , Marlies Hulscher 1 , M Todd Greene 3, 4, 5
Affiliation  

Objective To examine the extent to which acute care hospitals in the Netherlands have adopted recommended practices to prevent catheter-associated urinary tract infection (CAUTI), central line-associated bloodstream infection (CLABSI), ventilator-associated pneumonia (VAP), and Clostridioides difficile infection (CDI). Methods Between 18 July 2017 and 31 October 2017, we surveyed the infection prevention teams of all acute care hospitals in the Netherlands. The survey instrument was based on the 'Translating Healthcare-Associated Infection Prevention Research into Practice' (TRIP) questionnaire and adapted to the Dutch context. Descriptive statistics were used to examine the reported regular use of CAUTI, CLABSI, VAP, and CDI prevention practices as well as the hospital characteristics. Results Out of 72 eligible hospitals, 47 (65.3%) responded. Surveillance systems for monitoring CAUTI, CLABSI, VAP, and CDI were present in 17.8, 95.4, 26.2, and 77.3% of hospitals, respectively. Antimicrobial stewardship programs have been established in 91.5% of participating hospitals. For CAUTI, the majority of hospitals regularly used aseptic technique during catheter insertion (95%) and portable bladder ultrasound scanners (86.1%). Intermittent catheterization and catheter stop-orders were regularly used by 65.8 and 62.2% of hospitals. For CLABSI, all hospitals regularly used maximum sterile barrier precautions and chlorhexidine gluconate for insertion site antisepsis. Avoidance of the femoral site for central line insertions was regularly used by 65.9% of hospitals. Urinary catheters and central-lines impregnated with antibiotics or antiseptics were rarely used (≤ 5%). Selective decontamination strategies for preventing VAP were used in 84% of hospitals. With the exception of disposable thermometers (31.8%), all prevention practices to prevent CDI were regularly used by more than 80% of hospitals. Conclusions Most Dutch hospitals report regular use of recommended practices for preventing CLABSI and CDI. Several specific practices to prevent CAUTI and VAP were less frequently used, however, providing an opportunity for improvement.

中文翻译:

荷兰的感染预防措施:国家调查的结果。

目的探讨荷兰的急诊医院在多大程度上采用了推荐的措施来预防导管相关性尿路感染(CAUTI),中心线相关性血液感染(CLABSI),呼吸机相关性肺炎(VAP)和艰难梭菌感染(CDI)。方法在2017年7月18日至2017年10月31日期间,我们对荷兰所有急诊医院的感染预防团队进行了调查。该调查工具基于“将医疗保健相关的感染预防研究转化为实践”(TRIP)问卷,并且适用于荷兰语。描述性统计数据用于检查所报告的CAUTI,CLABSI,VAP和CDI预防措施的常规使用情况以及医院的特征。结果在72家符合条件的医院中,有47家(65。3%)回应。分别有17.8%,95.4%,26.2%和77.3%的医院拥有用于监视CAUTI,CLABSI,VAP和CDI的监视系统。已在91.5%的参与医院中制定了抗菌素管理计划。对于CAUTI,大多数医院在导管插入期间(95%)和便携式膀胱超声扫描仪(86.1%)定期使用无菌技术。65.8%和62.2%的医院定期使用间歇性导尿和停止导管。对于CLABSI,所有医院都定期使用最大程度的无菌屏障预防措施和葡萄糖酸氯己定对插入部位进行防腐。65.9%的医院经常使用避免股骨中心线插入的方法。很少使用浸有抗生素或防腐剂的导尿管和中心线(≤5%)。84%的医院采用了预防VAP的选择性去污策略。除一次性温度计(31.8%)外,超过80%的医院定期采用所有预防CDI的预防措施。结论大多数荷兰医院报告定期使用推荐的方法来预防CLABSI和CDI。很少使用几种防止CAUTI和VAP的特定做法,但是,这为改进提供了机会。
更新日期:2020-04-22
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