Epidemiological surveillance of intravascular catheter-related infections in the multidisciplinary healthcare setting: problems and solution ways

Abstract

The issue of prevention and treatment of healthcare-associated infections (HCI), and in particular intravascular catheter-related infections associated with (ICRI), still remains unresolved. The purpose of the work was to determine the shortcomings in the epidemiological surveillance (ES) for ICRI and the ways to correct them, with the further development of an effective system of ES for ICRI in multidisciplinary healthcare settings. In 2019‒2020, a comprehensive epidemiological study was conducted. It was conducted on the basis of the surgical and intensive care units in multidisciplinary healthcare settings. The study included a retrospective epidemiological analysis of 160 medical records of inpatients on the use of intravascular catheters, a cross-sectional epidemiological study of the use of intravascular catheters, prospective epidemiological observation of 94 patients with intravascular catheters (n=149), a cross-sectional epidemiological study of the level of knowledge, attitude and practice of using intravascular catheters and adherence to infection control rules of 123 healthcare workers (HCW). No cases of catheter-related phlebitis or other ICRI were documented in the medical records of inpatients. An analysis of the completeness of the documentation of the catheterization procedure revealed that in 100% of cases, the probable duration of catheterization, the results of daily observation of the catheterization site, information about the change of dressings and washing of the vascular catheter were not routinely recorded. HCW have an insufficient level of knowledge about epidemiological features, infection control and prevention of ICRI. The majority of HCW (80.0±3.65%) feel the need to receive additional information regarding possible complications of vascular catheterization, infection control, and prevention of ICRI. Taking into account the mentioned shortcomings, a system of ES for ICRI in the multidisciplinary healthcare setting was developed. It includes three structural modules: informational, diagnostic and management. The developed ES system according to the ICRI is suitable for use in multidisciplinary healthcare settings and can be adapted according to the material and technical capacity of the healthcare settings. Keywords: infection control, catheter-related phlebitis, catheter-related bloodstream infections, epidemic situation.