Research Information System
Thesis Type: Doctorate
Institution Of The Thesis: Gazi University, Turkey
Approval Date: 2016
Thesis Language: Turkish
Student: Gülay Yazıcı
Supervisor: HÜLYA BULUT
Abstract:Health care-associated infections (HCAIs) are high morbidity and mortality infections that prolong the duration of hospitalisation and increase the costs of additional treatment. The rate of infections is higher in intensive care units (ICUs) due to the greater frequency of invasive interventions. Ventilator-associated pneumonias (VAPs), catheter-associated urinary system infections (CA-USIs) and catheter-associated bloodstream infections (CA-BIs) are the most commonly observed HCAIs in the intensive care units. This study aimed to evaluate the efficacy of care package for the prevention of infections commonly observed in an intensive care unit. The study was conducted as a prospective and interventional study in the Anaesthesiology and Reanimation Unit of the İbni Sina Training, Research and Application Hospital, which is affiliated with the Ankara University School of Medicine, between April 1, 2015 and September 30, 2015. The study was performed in three stages. The first stage, the ICU nurses were trained regarding the care packages and prevention of infection. In the second stage, the effects of the care packages on the infection rates were examined after the training, and the nurses were given feedback concerning the areas in which they experienced problems. In the third stage, the effect of compliance to the care package on rates of infection was investigated after feedback was given to the nurses. Statistical analyses and calculations were performed using the IBM SPSS Statistics 21.0 software. In evaluation of the data; descriptive statistics were described using frequency and percentage, while compliance and infection rates between different periods were compared using the Chi-square test, mean±standard deviation (mean±SD) and median (minimummaximum). For all results, p value <0.05 was considered as statistically significant. Compliance rates to the VAP care package were calculated as 44.4% (n=564) for the period between April and June, and 40.0% (n=490) for the period between July and September. The difference between the compliance rates was found to be statistically significant (X2=4.091; p=0.043). Similarly, the compliance to CA-BI and CA-USI were found to decrease in the period between July and September compared to the period between April and June (p<0.001). For VAP, the infection rates for 1000 ventilator days in the periods between January and March, April and June and July and September were determined as 23.4, 12.6 and 11.5, respectively. The infection rate was found to decrease in the period between April and June compared to the period between January and March; however, this was not statistically significant, and there was no significant decrease between the last two periods as well. The infection rate for CA-BI in the relevant periods were found to differ statistically; however, paired comparisons did not reveal any significant differences between the periods (p>0.05). When the infection rates were compared for the CA-USI, a greater number of infections was observed in the period between July and September compared to the other two periods, although these differences were not statistically significant (p>0.05). No statistically significant differences were identified in terms of infection rates between the April-June and January-March periods. In conclusion; the application of a Care Package along with a training program prepared according to evidence-based guidelines was found to decrease infection rates by increasing compliance.