Title

Examining the association between chest tube-related factors and the risk of developing healthcare-associated infections in the ICU of a community hospital: A retrospective case-control study

Document Type

Article

Publication Date

2009

Publication Title

Intensive and Critical Care Nursing

Volume

25

Issue

1

First Page

38

Last Page

44

DOI

10.1016/j.iccn.2008.07.001

Keywords

article, artificial ventilation, Blood stream infection, Canada, Case-Control Studies, case control study, Chest tube, Chest Tubes, chi square distribution, Chi-Square Distribution, community hospital, Critical Care, cross infection, female, health service, Health Services Needs and Demand, Hospitals, Community, human, Humans, Infection control, intensive care, intensive care unit, Intensive Care Units, length of stay, male, methodology, middle aged, multivariate analysis, Nosocomial infection, Ontario, pneumonia, regression analysis, Respiration, Artificial, risk assessment, risk factor, Risk Factors, statistics, Thoracostomy, tube

Abstract

Objectives: The study examined the association between chest tube-related factors and the risk for developing healthcare-associated infections (HAI). Research methodology: A case-control retrospective chart review was performed on 120 intensive care patients. Eligible patients were 18 years of age or older, had been in the intensive care unit (ICU) for 48 h or more, and had one or more chest tubes. Setting: A 20-bed medical-surgical intensive care unit (ICU) of a community hospital in south-western Ontario, Canada. Main outcome measures: Documented diagnosis of hospital-acquired pneumonia or bloodstream infection. Results: The variable chest tube days was the only chest tube-related factor that was independently associated with HAI (OR = 5.78; p = 0.013). Mechanical ventilation (OR = 4.88; p = 0.002) and outcome length of stay (OR = 0.72; p ≤ 0.001) were also independently associated with HAI. Conclusions: The risk of infection among patients with chest tubes increases as the number of chest tube days increases. Infection is likely to happen early during admission, which necessitates stringent adherence to infection control strategies, especially during that time frame. © 2008 Elsevier Ltd. All rights reserved.