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Open and closed models of intensive care unit have different influences on infectious complications in a tertiary
Karim El-Kersh1, Juan Guardiola1, Rodrigo Cavallazzi1
1Department of Internal Medicine, Division of Pulmonary, Critical Care, and Sleep Disorders Medicine, University of Louisville, Louisville, KY.
Abstract:
Infectious complications in the intensive care unit (ICU) are associated with higher morbidity, mortality, and increased health care use. Here, we report the results of implementing 2 different models (open vs closed) on infectious complications in the ICU. The closed ICU model was associated with 52% reduction in ventilator-associated pneumonia rate (P = .038) and 25% reduction in central line-associated bloodstream infection rate (P = .631). We speculate that a closed ICU model allows clinical leadership centralization that further facilitates standardized care delivery that translates into fewer infectious complications.
Insights
Implementing a closed intensive care unit (ICU) model significantly reduced ventilator-associated pneumonia rates by 52%. This model may improve patient outcomes by centralizing leadership and standardizing care delivery in ICUs.
Area of Science:
- Critical Care Medicine
- Infectious Disease Prevention
- Healthcare Management
Background:
- Infectious complications in the intensive care unit (ICU) increase patient morbidity, mortality, and healthcare costs.
- Comparing open versus closed ICU models is crucial for optimizing patient safety and care delivery.
Purpose of the Study:
- To evaluate the impact of implementing open versus closed ICU models on infectious complication rates.
- To determine if a closed ICU model leads to a reduction in specific ICU-acquired infections.
Main Methods:
- The study compared infectious complication rates between two distinct ICU operational models: open and closed.
- Data on ventilator-associated pneumonia and central line-associated bloodstream infections were collected and analyzed.
Main Results:
- The closed ICU model demonstrated a 52% reduction in ventilator-associated pneumonia rates (P=.038).
- A 25% reduction in central line-associated bloodstream infection rates was observed in the closed ICU model (P=.631).
Conclusions:
- A closed ICU model is associated with a significant decrease in ventilator-associated pneumonia.
- Centralized clinical leadership and standardized care within a closed ICU model may contribute to fewer infectious complications.
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