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Group 4 Infection & Patient Visibility. Infection Case Study. Hip hemiarthroplasty after displaced femoral neck fracture: a survivorship analysis Femoral neck fracture – broken knee joint
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Infection Case Study Hip hemiarthroplasty after displaced femoral neck fracture: a survivorship analysis • Femoral neck fracture – broken knee joint • Total Hip Arthroplasty – Yes….better results for patients than internal fixation and hemiarthroplasty. • Some Results for age group 60 + differ from this: “0-35 % dislocation cases” – quite high • REASON ? Major one is comorbidities!
Infection Case Study Biomarkers as a Tool for Management of Immunosuppression in Transplant Patients • Immuno-suppressive drugs • Without immunosuppression therapy, transplatationsurgery could be fatal. • Therapeutic drug monitoring – DOES NOT reflect adverse effects to immune cells. • Pharmacodynamicmonitoring (biomarkers)
Infection Case Study Problem of infection in the ICU • Infections possible - ventilator-associated pneumonia, catheter-associated urinary tract infection, catheter-related bloodstream infection • Need to be attentive to horizontal infection and use proper antibiotics for multi-resistant bacteria like MRSA.
Infections in the ICU • Managing infection in the critical care unit: how can infection control make the ICU safe? • Infection Control in the ICU • Device Related Nosocomial Infection In ICU
Types of Infections Antibiotic Resistance Pathogens Ventilator Associated Pneumonia Catheter-related Infections
Example: Ventilator Associated Pneumonia • Modifiable • Frequency of ventilator circuit changes • Antibiotic usage • Nonmodifiable • Patient age and gender • Severity of illness • Coma Risk Factors Prevention Bronchoscopic techniques Nonbronchoscopic techniques Balance between initial antibiotic and overuse
Improvement Stories Decrease Infection in Neonatal Intensive Care Unit Source: Improvement Report: Reducing the Incidence of Nosocomial Infection of Very Low Birth Weight Infants http://www.ihi.org/IHI/Topics/PatientSafety/SafetyGeneral/ImprovementStories/ReduceIncidenceofNosocomialInfectionofVLBWInfants.htm Image: www.mauryregional.com/NICU.htm
Improvement Stories Long-Term Acute Care Hospital Source: Reducing Hospital-Acquired Infections in a Long-Term Acute Care Hospital http://www.ihi.org/IHI/Topics/HealthcareAssociatedInfections/InfectionsGeneral/ImprovementStories/ReducingHAIinLongTermAcuteCareHospital.htm
Improvement Stories Pursuing perfection in fighting with VAP and CR-BSIs in ICU Bundle Methodology Source: Pursuing Perfection: Report from HealthPartners’ Regions Hospital on Reducing Hospital-Acquired Infection: Ventilator-Associated Pneumonia and Catheter-Related Bloodstream Infection http://www.ihi.org/IHI/Topics/CriticalCare/IntensiveCare/ImprovementStories/PursuingPerfectionReportfromHealthPartnersonReducingVAPCRBSI.htm VAP: Ventilator-Associated Pneumonia CR-BSIs: Catheter-Related Bloodstream Infections