• Pediatric Infection and Vaccine
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• 제28권3호
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• pp.133-143
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• 2021

목적: 본 연구는 신생아중환자실에서 중심정맥관 관련 혈류감염 발생률을 확인하고, 이러한 환자들의 임상적 특성 및 원인균에 대해 분석하여 향후 신생아중환자실 내 혈류감염 예방 및 치료 지침의 기초 자료로 활용하고자 수행되었다. 방법: 2016년 1월부터 2020년 12월까지 분당서울대학교병원 신생아중환자실에 입원한 환자 중 중심정맥관 관련 혈류감염이 발생한 환자들을 대상으로 후향적 의무기록 분석을 하였다. 결과: 5년의 연구 기간동안 총 45명의 환자에게서 53례의 중심정맥관 관련 혈류감염이 확인되었고, 18,622 카테터-일 동안 발생률은 1,000 카테터-일 당 2.85건이었다. 가장 흔한 중심정맥관 종류는 말초 혈관 삽입형 중심정맥관이었다. 총 57균주가 분리되었고, 이 중 그람 양성균, 그람 음성균, 진균이 각각 57.9% (n=33), 36.8% (n=21), 5.3% (n=3)이었다. 가장 흔한 균은 Staphylococcus aureus (n=12, 21%) 와 coagulase-negative staphylococci (n=12, 21%)였고, 그 다음으로는 Klebsiella aerogenes (n=8, 14%)였다. 균혈증 평균 지속시간은 2일이었고, 19건에서는 3일 이상 균혈증이 지속되었다. 균혈증 발생으로부터 14일 이내에 사망한 사례는 총 6건(13.3%)이었다. 결론: 본 연구에서는 신생아중환자실 내 중심정맥관 관련 혈류감염의 발생률과 원인균 분포에 대해 분석하였다. 중심정맥관 관련 혈류감염에 대한 지속적인 모니터링은 경험적 항생제 사용 지침을 수립하기 위한 중요한 기반이 될 수 있으며, 감염예방 지침 실행의 필요성 및 이에 따른 영향을 평가하는 데에 도움이 될 것으로 생각된다.

• Journal of Korean Biological Nursing Science
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• 제18권4호
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• pp.257-263
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• 2016

Background: This study purposed to examine how the incidence of the central line-associated bloodstream infection (CLABSI) in a operating room (OR) is affected by bundle application on central line insertion (CLI) practice. Methods: The study design was a pretest-posttest experimental trial. The subjects were 83 patients before the bundle application on CLI and 70 patients after. Results: The compliance(%) of bundle on CLI of among those who observed all of the five items increased from 7.2% before the intervention to 72.9% after. By items, compliance with the maximal barrier precaution was 100% for the use of a mask and cap before and after the intervention, but increased from 73.5% before the intervention to 88.6% after for the hand hygiene, from 73.5% to 88.6% for the use of a sterile gown, and from 9.6% to 75.7% for the use of a sterile large drape covering the whole body. CLABSI did not happen on CLI either before or after the application of the bundle intervention. Conclusion: Bundle application increased compliance with the use of a sterile gown and the use of a sterile large drape. However, its effect in the prevention of CLABSI was not clear probably due to the short period of intervention in a single hospital.

• 대한간호학회지
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• 제50권4호
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• pp.541-553
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• 2020

Purpose: In spite of the recent application of a general infection control method, central line-associated infections is still relatively high in Korea. Central line bundle with Chlorhexidine gluconate (CHG) tegaderm dressing was reported to be effective in reducing catheter colonization and central line-associated bloodstream infections (CLABSI). Therefore, this study aimed to examine the incidences of catheter colonization occurrence and CLABSI while using Tegaderm vs. CHG Tegaderm dressings. Methods: We used a descriptive design. 400 patients who had central venous catheters were selected from four hospitals in the Korean National Healthcare-associated Infections Surveillance System. Of all subjects, 200 used Tegaderm™ (Tegaderm group), and the remaining 200 used CHG Tegaderm (CHG Tegaderm group) dressing at the catheter insertion site. Data were analyzed using the χ² test or Fisher's exact test, t-test, and logistic regression analysis using SPSS WIN 21.0. Results: In the Tegaderm and CHG Tegaderm groups, CLABSI incidences were 5.89 and 1.79 per 1,000 catheter-days, catheter colonization incidences were 3.93 and 1.43 per 1,000 catheter-days, and central line bundle compliance rates were 26.0% and 49.0%, respectively. Catheter colonization risk factors were 'reinsertion after failure' and 'Tegaderm dressing' at the central line insertion site. CLABSI risk factors were 'incomplete performance of 7 central line bundle items' and 'Tegaderm dressing' at the central line insertion site. Conclusion: A further prospective study is needed to examine the effects of central line bundle with CHG Tegaderm dressing, avoiding central line reinsertion after failure, and improving the bundle compliance in reducing catheter colonization and CLABSI.

• 간호행정학회지
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• 제18권2호
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• pp.244-250
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• 2012

Purpose: The purpose of this study was to investigate the effect of a short message service intervention on adherence to maximal barrier precautions (MBP) and catheter-related blood stream infections. Method: The data were collected from March to September, 2008, at an 826-bed university-affiliated hospital in Daejeon. The study participants were 24 physicians who were inserting central catheters and 133 patients (control group 78 and intervention group 55) with central catheter insertions. The researcher sent the message (adherence to MBP and optimal recommendations) to each internal medicine doctor using the short message service (SMS) for cellular phones. Messages were sent monthly for 3 months. Data were analyzed by chi-square test and t-test using SPSS 12.0 windows program. Result: Adherence to maximal barrier precautions was significantly increased from 44.9% to 69.1% (p=.006) after the SMS intervention. But changes in the rate of CRBSI (catheter related blood stream infection) between the intervention group (1.89) and the control group (4.45) were not significant (p=.323). Conclusions: The results indicate that the SMS intervention is effective in increasing the adherence to maximal barrier precautions and the SMS intervention can be recommended for utilization in infection control nursing practice.