Journal article
Certain Rooms in Intensive Care Units May Harbor Risk for Clostridioides difficile Infection
Surgical infections, v 23(2), pp 159-167
Mar 2022
PMID: 35020481
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
infection (CDI) is a common and sometimes life-threatening illness. Patient-, care-, and room hygiene-specific factors are known to impact CDI genesis, but care provider training and room topography have not been explored. We sought to determine if care in specific intensive care unit (ICU) rooms asymmetrically harbored CDI cases.
Surgical intensive care unit (SICU) patients developing CDI (July 2009 to June 2018) were identified and separated by service (green/gold). Each service cared for their respective 12 rooms, otherwise differing only in resident team composition (July 2009 to August 2017: green, anesthesia; gold, surgery; August 2017 to June 2018: mixed for both). Fixed/mobile room features and provider traffic in three room zones (far/middle/near in relation to the toilet) were compared between high-/low-incidence rooms using observation via telecritical care video cameras.
Seventy-four new CDI cases occurred in 7,834 consecutive SICU admissions. In period one, green CDI cases were almost double gold cases (39 vs. 21; p = 0.02) but were similar in period two in which trainee service allocation intermixed. High-incidence rooms had closer toilet-to-intravenous pole proximity than low-incidence rooms (7.7 + 1.8 feet vs. 3.9 + 1.5 feet; p = 0.02). High-incidence rooms consistently housed mobile objects (patient bed, table-on-wheels) farther away from the toilet. Although physician time spent in each zone was similar, nurses spending more than 15 minutes in-room more frequently stayed in the far/middle zones in high-incidence rooms.
Distinct SICU room features relative to toilet location and bedside clinician behaviors interact to alter patient CDI acquisition risk. This suggests that CDI risk occurs as a structural aspect of ICU care, offering the potential to reduce patient risk through deliberate room redesign.
Metrics
Details
- Title
- Certain Rooms in Intensive Care Units May Harbor Risk for Clostridioides difficile Infection
- Creators
- Sarah Danehower - University of PennsylvaniaJared Lazorko - University of PennsylvaniaLewis J Kaplan - University of PennsylvaniaMark Fegley - University of PennsylvaniaJuliane Jablonski - University of Pennsylvania Health SystemLily Owei - University of PennsylvaniaMatthew J Ziegler - University of PennsylvaniaMichael Pisa - University of PennsylvaniaDavid Pegues - University of Pennsylvania Health SystemJose L Pascual - University of Pennsylvania
- Publication Details
- Surgical infections, v 23(2), pp 159-167
- Publisher
- Mary Ann Liebert
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:000745633100001
- Scopus ID
- 2-s2.0-85125554073
- Other Identifier
- 991019353622104721
UN Sustainable Development Goals (SDGs)
This publication has contributed to the advancement of the following goals:
InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Infectious Diseases
- Surgery