Association between ventilator-associated events and implementation of acute respiratory distress syndrome (ARDS) ventilator weaning protocol.

BACKGROUND: Acute respiratory distress syndrome (ARDS) is a severe and life-threatening condition that can occur in critically ill patients. Mechanical ventilation is a commonly used intervention with ARDS patients, but weaning patients off the ventilator can be challenging. An ARDSnet-like ventilator weaning protocol was implemented with the goal of reducing triggers for ventilator-associated events (VAEs). METHODS: The implementation of the new protocol was used to complete a retrospective investigation of patient outcomes for 1,233 ventilator periods. Periods were included between April and December 2022 for any ventilated patient lasting at least 4 days. National Health Care Safety Network VAE criteria were used to surveille the patient data. Triggers were based on the positive end-expiratory pressure increases or fraction of inspired oxygen (FiO2) increases. The preset weaning criteria was a reduction by 2 cmH2O per 24 hours. RESULTS: Of the total 1,233 individual ventilator periods, VAE criteria were met in 10%. Of the total 126 periods with VAE, 39.2% met the criteria for appropriate protocol implementation. There was a statistically significant relationship between VAE identification and implementation of the protocol. CONCLUSIONS: The implementation of a protocol for ventilator weaning affects the outcome of developing a VAE. The findings emphasize the importance of implementing the ARDS weaning protocol as a template to reduce the triggers for VAEs and improve overall patient outcomes.

An effective and automated approach for reducing infection risk from contaminated privacy curtains.

Privacy curtain contamination, including with multidrug-resistant organisms, and the associated infection transmission risks have been well described; however, current approaches for addressing these risks and available guidance are limited. The present study describes the successful reduction of curtain contamination in five different units within a tertiary care hospital utilizing continuous dry hydrogen peroxide (DHP). Microbial load was reduced by 99.47 percent on Day 1 and statistically significant reductions were maintained throughout the 28-day study.

Evaluation of dry hydrogen peroxide in reducing microbial bioburden in a healthcare facility.

BACKGROUND: Standard manual cleaning and disinfection practices are often inadequate. Persistent contamination in the environment poses an infection risk that may be mitigated by no-touch disinfection systems. This study evaluates the efficacy of dry hydrogen peroxide (DHP) on microbial air and surface contamination as an adjunct to routine cleaning and disinfection in a large urban hospital. METHODS: Surface samples were collected in five different hospital units, two pediatric and three adult, after manual cleaning on multiple days before and after DHP implementation. Air samples were also collected in each unit pre- and post-DHP use. Data outcomes were reported as colony forming units (CFU) with species identification. RESULTS: The overall mean surface microbial burden was reduced by 96.5 percent for all units post-DHP compared to baseline (P < 0.001), with the greatest reductions achieved on privacy curtains (99.5 %). Mean microbial air sample counts were also reduced post-DHP compared to pre-DHP. CONCLUSIONS: This study demonstrates that DHP was effective in reducing both air and surface microbial contamination in a variety of settings within a large, tertiary care hospital.

Infection preventionists and laboratorians: Case studies on successful collaboration.

Efforts to reduce the incidence of hospital-acquired infection (HAI) remain a significant focus for health care facilities, particularly in this era of drug-resistant organisms. With as many as 1 in every 25 hospitalized patients acquiring an infection, the need to minimize the risk of HAIs is widely recognized as critical. Advances in the fields of biomedical technology, microbiology, pharmacology, and infection control and prevention, among others, have played a tremendous role in these efforts. However, evidence suggests that a key element in this battle against HAIs is missing: collaboration and communication between these groups in health care facilities-particularly in microbiology and infection prevention. The need for collaboration between infection preventionists (IPs) and laboratorians has been addressed in the literature; however, a survey conducted by the APIC and the American Society for Microbiology demonstrated that both IPs and laboratorians feel they lack the tools to engage in this collaboration. This article addresses strategies for a working partnership between IPs and laboratorians and reports 3 case studies on successful collaborations at major medical centers.