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Significant Reduction in External Ventricular Drain-Related Infections After Introducing a Novel Bundle Protocol: A
Yoon-Hee Choo1, Youngbo Shim2,3, Hyeseon Kim4
1Department of Neurosurgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Journal of Korean Medical Science
|December 26, 2023
Summary
Implementing an external ventricular drain (EVD)-related infection (ERI) bundle significantly reduced infection rates in neurosurgical patients. This protocol, similar to central line-associated bloodstream infection bundles, proved highly effective.
Area of Science:
- Neurosurgery
- Infectious Disease Prevention
- Patient Safety
Background:
- External ventricular drain (EVD)-related infection (ERI) is a significant neurosurgical complication.
- ERI shares similar pathophysiology with central line-associated bloodstream infections (CLABSIs), originating from skin bacteria.
- Bundle management strategies have proven effective in reducing CLABSI rates.
Purpose of the Study:
- To develop and evaluate the effectiveness of an ERI-bundle protocol.
- To adapt successful CLABSI bundle strategies for EVD management.
- To reduce the incidence of ERI in neurosurgical patients.
Main Methods:
- A before-and-after trial was conducted from November 2016 to November 2021.
- ERI rates were compared for two years pre- and three years post-implementation of the ERI-bundle protocol.
- Logistic regression analysis identified factors contributing to ERI.
Main Results:
- The study analyzed 183 patients and 2,381 catheter days.
- ERI rates significantly decreased from 16.7% (14.35 per 1,000 catheter days) to 4.0% (3.21 per 1,000 catheter days) (P = 0.004).
- The ERI-bundle protocol demonstrated a substantial reduction in infection rates.
Conclusions:
- The ERI-bundle protocol was highly effective in reducing external ventricular drain infections.
- Implementing this bundle is a valuable strategy for improving neurosurgical patient safety.
- The findings support the adaptation of CLABSI prevention bundles for EVDs.
