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Evaluation of a New Method of Detection of Nosocomial Infection in the Pediatric Intensive Care Unit: The Infection Control Sentinel Sheet System

Published online by Cambridge University Press:  21 June 2016

E.L. Ford-Jones ,
C.M. Mindorff ,
E. Pollock ,
R. Milner ,
D. Bohn ,
J. Edmonds ,
G. Barker  and
R. Gold
E.L. Ford-Jones*
Affiliation:
Division of Infection Diseases, Department of Pediatric., The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
C.M. Mindorff
Affiliation:
Division of Infection Diseases, Department of Pediatric., The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
E. Pollock
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
R. Milner
Affiliation:
Department of Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario, Canada
D. Bohn
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
J. Edmonds
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
G. Barker
Affiliation:
Department of Intensive Care Medicine The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
R. Gold
Affiliation:
Division of Infection Diseases, Department of Pediatric., The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
*
Division of Infectious Disease, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, CanadaM5G 1X8
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Abstract

To improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS).

Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the “gold standard” became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 10 , Issue 11 , November 1989 , pp. 515 - 520
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1989

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References

1. Haley, RW, Culver, DH, White, JW, et al. The efficacy of infection surveillance and control programs in preventing nosocomial infections in US hospitals. Am J Epidemiol. 1985;121:182–205.CrossRefGoogle ScholarPubMed
2. Eickhoff, TC, Brachman, PS, Bennett, JV, et al. Surveillance of nosocomial infections in community hospitals, I: surveillance methods, effectiveness and initial results. J Infect Dis. 1969;120:305–317.CrossRefGoogle ScholarPubMed
3. Wenzel, RP. Osterman, CA, Hunting, KJ, Gwaltney, JM Jr. Hospital-acquired infections, I: surveillance in a university hospital. Am J Epidemiol. 1976;103:251–260.CrossRefGoogle ScholarPubMed
4. Thoburn, R. Fekety, FR. Cluff, LE. Infections acquired by hospitalized patients. Arch intern Med. 1968;121:1–10.CrossRefGoogle ScholarPubMed
5. Haley, RW, Schaberg, DR. McClish, DK, et al. This accuracy of retrospective C hart review in measuring nosocomial infection rates. Am J Epidemiol. 1980;111:516–533.CrossRefGoogle Scholar
6. Freeman, J, McGowan, JE Jr. Methodologie issues in hospital epidemiology, 1: rates, case finding and interpretation. Rev Infect Dis. 1981;3:658–667.CrossRefGoogle Scholar
7. Kislak, JW, Eickhoff, TC, Finland, M. Hospital-acquired infections and antibiotic usage in the Boston City Hospital. N Engl J Med. 1964;271:834–835.CrossRefGoogle ScholarPubMed
8. Thompson, RL. Surveillance and reporting of nosocomial infections. In: Wenzel, R, ed. Prevention and Control of Nosocomial Infections. Baltimore, Md: Williams & Wilkins;1987:70–82.Google Scholar
9. Milliken, J, Tait, GA, Ford-Jones, L, Mindorff, CM, Gold, R, Mullins, G. Nosocomial infections in a pediatric intensive care unit. Crit Care Med. 1988;16:233–237.CrossRefGoogle Scholar
10. Simon, AE, Ricci, J, Lau, A, Bannatyne, R, Ford-Jones, EL. Pseudobac-teremia due to Pseudomonas fluorescens . Pediatr Infect Dis. 1985;4:508–512.Google Scholar
11. Ford-Jones, EL, Mindorff, CM, Gold, R. Satellite infection control committees within the hospital: decentralizing for action. Infect Control Hosp Epidemiol. 1989;10:368–370.CrossRefGoogle Scholar
12. Hofherr, L. Nosocomial infection surveillance techniques-a review. Am J Inject Control. 1979;7:12–15.Google ScholarPubMed
13. Andrews, C. ICPs use epidemiology listings to pick up potential infections. Hospital Infection Control. 1988;127:15.Google Scholar