A study on APACHE II severity scoring system in Intensive Care Unit Hospital University Sains Malaysia

Sistem penilaian keterukan pesakit telah digunakan secara meluas untuk mengkaji keadaan pesakit yang dimasukkan ke unit rawatan rapi samada untuk melihat perubahan fisiologi atau keberkesanan rawatan dan menilik kadar kematian. APACHE ll merupakan system penilaian yang selalu digunakan kerana ia adalah senang dikendalikan dan mudah diperolehi. Selama 12 bulan, dari Januari 2000 ke Disember 2000, seramai 180 pesakit telah dimasukkan ke unit rawatan rapi, hospital Universiti Sains Malaysia. Kemasukkan adalah berdasarkan criteria yang telah ditetapkan di dalam kajian ini. Severity scoring system have been widely used for assessment of patients admitted to intensive care unit whether to see the physiological derangement or the effectiveness of the treatment and prediction of mortality rate. APACHE II is the most commonly used severity scoring system because it is user friendly and easily available. For the past 12 months between January 2000 to December 2000, a total of 180 patients were admitted to the intensive care unit, Hospital University Sains Malaysia. Admission was based upon the criteria that have been tailored towards the study

Effectiveness of video tutorial on compliance of medical officers to sequence of intubation protocol in simulated Covid-19 patients

The use of full PPE, aerosol box, and video laryngoscope are recommended when performing intubation on a Covid-19 patient. However, this technique may be difficult for medical officers unfamiliar with the intubation protocol sequence, especially for those with less experience in anaesthesia. Video tutorials may play a vital role in improving the technique. This study evaluated the compliance of medical officers in our anaesthesia department to the intubation protocol and the effect on compliance before and after viewing the video tutorial on the protocol. A total of 70 medical officers (n = 70) in the Department of Anaesthesia, Hospital Universiti Sains Malaysia, Kelantan participated in this study. The participants performed the intubation protocol sequence on a simulated Covid-19 mannequin. Participants then viewed a video tutorial after their initial attempt and repeated the intubation sequence afterward. The outcomes measured include the proportion of participants compliant with the intubation protocol, the association between years of experience and compliance, and the compliance score before and after the video tutorial. There was no significant association between years of anaesthesia and compliance score (p = 0.058). A large proportion of the subjects were compliant (n = 57, 81.4%). There was a significant difference between initial and repeated compliance score post-video tutorial (p < 0.05). Years of experience in anaesthesia was not a determining factor for compliance with the intubation protocol sequence on simulated Covid-19 patients. However, the video tutorial played a significant role in improving compliance with the intubation sequence

Six-year study on peripheral venous catheter-associated BSI rates in 262 ICUs in eight countries of South-East Asia: International Nosocomial Infection Control Consortium findings

Short-term peripheral venous catheter-associated bloodstream infection rates have not been systematically studied in Asian countries, and data on peripheral venous catheter-associated bloodstream infections incidence by number of short-term peripheral venous catheter days are not available. Prospective, surveillance study on peripheral venous catheter-associated bloodstream infections conducted from 1 September 2013 to 31 May 2019 in 262 intensive care units, members of the International Nosocomial Infection Control Consortium, from 78 hospitals in 32 cities of 8 countries in the South-East Asia Region: China, India, Malaysia, Mongolia, Nepal, Philippines, Thailand, and Vietnam. For this research, we applied definition and criteria of the CDC NHSN, methodology of the INICC, and software named INICC Surveillance Online System. We followed 83,295 intensive care unit patients for 369,371 bed-days and 376,492 peripheral venous catheter-days. We identified 999 peripheral venous catheter-associated bloodstream infections, amounting to a rate of 2.65/1000 peripheral venous catheter-days. Mortality in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.53% and 12.21% in patients with peripheral venous catheter-associated bloodstream infections. The mean length of stay in patients with peripheral venous catheter but without peripheral venous catheter-associated bloodstream infections was 4.40 days and 7.11 days in patients with peripheral venous catheter and peripheral venous catheter-associated bloodstream infections. The microorganism profile showed 67.1% were Gram-negative bacteria: (22.9%), spp (10.7%), (5.3%), spp. (4.5%), and others (23.7%). The predominant Gram-positive bacteria were (11.4%). Infection prevention programs must be implemented to reduce the incidence of peripheral venous catheter-associated bloodstream infections

International Nosocomial Infection Control Consortium report, data summary of 50 countries for 2010-2015: Device-associated module

•We report INICC device-associated module data of 50 countries from 2010-2015.•We collected prospective data from 861,284 patients in 703 ICUs for 3,506,562 days.•DA-HAI rates and bacterial resistance were higher in the INICC ICUs than in CDC-NHSN's.•Device utilization ratio in the INICC ICUs was similar to CDC-NHSN's. Background: We report the results of International Nosocomial Infection Control Consortium (INICC) surveillance study from January 2010-December 2015 in 703 intensive care units (ICUs) in Latin America, Europe, Eastern Mediterranean, Southeast Asia, and Western Pacific. Methods: During the 6-year study period, using Centers for Disease Control and Prevention National Healthcare Safety Network (CDC-NHSN) definitions for device-associated health care-associated infection (DA-HAI), we collected prospective data from 861,284 patients hospitalized in INICC hospital ICUs for an aggregate of 3,506,562 days. Results: Although device use in INICC ICUs was similar to that reported from CDC-NHSN ICUs, DA-HAI rates were higher in the INICC ICUs: in the INICC medical-surgical ICUs, the pooled rate of central line-associated bloodstream infection, 4.1 per 1,000 central line-days, was nearly 5-fold higher than the 0.8 per 1,000 central line-days reported from comparable US ICUs, the overall rate of ventilator-associated pneumonia was also higher, 13.1 versus 0.9 per 1,000 ventilator-days, as was the rate of catheter-associated urinary tract infection, 5.07 versus 1.7 per 1,000 catheter-days. From blood cultures samples, frequencies of resistance of Pseudomonas isolates to amikacin (29.87% vs 10%) and to imipenem (44.3% vs 26.1%), and of Klebsiella pneumoniae isolates to ceftazidime (73.2% vs 28.8%) and to imipenem (43.27% vs 12.8%) were also higher in the INICC ICUs compared with CDC-NHSN ICUs. Conclusions: Although DA-HAIs in INICC ICU patients continue to be higher than the rates reported in CDC-NSHN ICUs representing the developed world, we have observed a significant trend toward the reduction of DA-HAI rates in INICC ICUs as shown in each international report. It is INICC's main goal to continue facilitating education, training, and basic and cost-effective tools and resources, such as standardized forms and an online platform, to tackle this problem effectively and systematically