Effectiveness of a Standardized External Ventricular Drain Placement Protocol for Infection Control

Area of Science:

• Neurosurgery
• Infectious Disease Prevention

Background:

• External ventricular drains (EVDs) are commonly placed by neurosurgical residents.
• Standardized protocols may improve EVD placement and maintenance.
• Reducing EVD-related infections is a critical patient safety goal.

Purpose of the Study:

• To evaluate the efficacy of a standardized protocol for external ventricular drain (EVD) placement.
• To assess the incidence of EVD-related infections (ERIs) and complications.
• To identify risk factors associated with EVD placement and maintenance.

Main Methods:

• A single-institution retrospective review of 428 EVD placements in 381 patients over 5 years.
• Analysis of adherence to a standardized EVD placement and maintenance protocol.
• Comparison of ERI rates based on patient demographics, EVD duration, and replacement procedures.

Main Results:

• Overall EVD infection rate was 1.86% (8 ERIs in 428 EVDs).
• Protocol compliance was high at 98.7%.
• EVD replacement through the same access site was associated with increased infection risk; drain duration was not.

Conclusions:

• Adherence to a standardized EVD placement protocol is associated with a low risk of external ventricular drain-related infections.
• Catheter replacement through the original insertion site increases the risk of EVD-related infection.
• Standardized protocols are valuable for safe EVD management.