0563

NURSING MANAGEMENT IN CONTROLLING NOSOCOMIAL INFECTION IN CARDIAC INTENSIVE CARE UNIT

Fu, L-J; Xu, X-M; He, P-P; Shen, H-Y

Shanghai Children��s Medical Center, Shanghai, China

Objective: Nosocomial infection complicates the clinical course and influences the prognosis of post-cardiac surgery patients. Nursing management plays an essential role in preventing Nosocomial infection. The purpose of the present work is to discuss the mechanisms of decreasing the incidence of nosocomial infection, reducing the length of time required for endotracheal intubation in cardiovascular intensive care unit (CICU).

Methods: Several steps were implemented to control nasocomial infection: periodic ICU room air surveillance testing, sampling air quality culture, emphasizing hand-washing, practicing sterilizing procedure for invasive care, and implementing unified respirator daily management. The management outcome indexes, nasocomial infection rate, mortality rate, length of Endotracheal intubation, and bacterial surveillance form humidifier are compared between 570 cases in 1997 and 1158 cases in 2000.

Results: In year 2000, more complicated congenital heart disease (60%) were operated in the hospital as compared to 1997 (31.8%). Infants who are younger than 1-year-old increased form 8.4% to 17.4% in 2000. The nosocomial infection rate drops from 4.6% to 0.9% in 2000 (P< 0.01). The mortality rate also decreases from 4.4% in 1997 to 1.6% in 2000 (P < 0.01).

In year 2000, 63.8% of patients could be weaned form ventilator within 12 hours of intubation. Since the unit utilizes one senior nurse to handle all respirator management, none of the oxygen humidifier bottle had positive

culture; and negative bacterial surveillance was found among staffs.

Conclusions: in year 2000, the volume of operated cases was about twice higher than that in 1997. Patients with young age and complex cardiac defects will come to the hospital for treatment. However, in spite the above factors, positive patients treatment outcomes are achieved through effective nursing management and useful clinical strategies. The data indicates that nursing management is a key point to ensure the quality of care and prevention of nosocomial infection.