Evaluation of a new method of detection of nosocomial infection in the pediatric intensive care unit: the Infection Control Sentinel Sheet System.

Abstract

To improve the efficiency of nosocomial infection detection, a highly structured system combining initial reporting by the bedside night nurse of symptoms possibly related to infection with follow-up by the infection control nurse (ICN) was developed: The Infection Control Sentinel Sheet System (ICSSS). Between July 1, 1987 and February 28, 1988, a prospective comparison of results obtained through ICSSS and daily bedside observation/chart review by a full-time trained intensivist was undertaken in the pediatric intensive care unit (PICU). Ratios of nosocomial infections and nosocomially-infected patients were 15.8 and 7.0 respectively among 685 admissions; included are seven infections identified only through the ICSSS so that the "gold standard" became an amalgamation of the two systems. The sensitivity for detection of nosocomially-infected patients by bedside observation/chart review and ICSSS was 100% and 87% respectively. The sensitivity for detection of standard infections (blood, wound and urine) was 88% and 85% respectively. The sensitivity for detection of nosocomial infections at all sites was 94% and 72% respectively. Missed infections were minor (e.g., drain, skin, eye), required physician diagnosis (e.g., pneumonia), were not requested on the sentinel sheet (SS) (e.g., otitis media), related to follow-up of deceased patients or were minor misclassifications or failures to associate with device (e.g., central-line related). Daily PICU surveillance by the ICN required only 20 minutes a day. The ICSSS appears highly promising and has many unmeasured benefits.

• Authors: E L Ford-Jones, C M Mindorff, E Pollock, R Milner, D Bohn, J Edmonds, G Barker, R Gold
• Journal: Infection control and hospital epidemiology (Infect Control Hosp Epidemiol) Vol. 10 Issue 11 Pg. 515-20 (Nov 1989) ISSN: 0899-823X [Print] United States
• PMID: 2685101 (Publication Type: Journal Article)

Topics

• Bias
• Canada
• Cross Infection (diagnosis, epidemiology)
• Data Interpretation, Statistical
• Evaluation Studies as Topic
• Humans
• Incidence
• Intensive Care Units, Pediatric
• Methods
• Nursing Assessment
• Nursing Diagnosis
• Nursing Records
• Prospective Studies
• Sensitivity and Specificity