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Hygienemaßnahmen auf Intensivstationen

Ergebnisse des nationalen Krankenhaus-Infektions-Surveillance-Systems (KISS)

Infection control measures in intensive care units

Results of the German Nosocomial Infection Surveillance System (KISS)

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Zusammenfassung

Hintergrund

Ziel dieser Befragung ist es zu ermitteln, inwieweit auf deutschen Intensivstationen (ITS) evidenzbasierte Empfehlungen zur Prävention nosokomialer Infektionen umgesetzt werden.

Methode

Es wurden 230 deutsche ITS des Krankenhaus-Infektions-Surveillance-Systems (KISS) zum Umgang mit Beatmungstuben, zentralen Gefäßkathetern (ZVK), Harnwegkathetern (HWK) und Methicillin-resistentem-Staphylococcus-aureus- (MRSA-)positiven Patienten befragt.

Ergebnisse

Auf 9% der ITS wird überwiegend nasal intubiert. Alle Präventionsmaßnahmen zur ZVK-Anlage werden auf 43% der ITS eingehalten. Jede dritte ITS betreibt ein mikrobiologisches Routinescreening an Urin. Harnwegkatheter werden auf 37% der ITS routinemäßig gewechselt. MRSA positive Patienten werden auf 5% der ITS nicht isoliert. Ein Aufnahmescreening von MRSA-Risikopatienten unterbleibt auf 16% der ITS.

Schlussfolgerungen

Auf vielen deutschen ITS sind evidenzbasierte Empfehlungen nicht implementiert. Fortbildung zur Qualitätssicherung ist unerlässlich.

Abstract

Background

Aim of this study was to determine to what extent evidence-based infection control recommendations are applied in German intensive care units (ICUs).

Methods

A questionnaire concerning handling of tubes, central vascular catheters (CVC), urinary tract catheters and methicillin-resistant Staphylococcus aureus (MRSA) positive patients was sent to 230 participants of the German Nosocomial Infection Surveillance System (KISS).

Results

Nasal intubation is routinely performed in 9% of ICUs, all recommended measures for CVC insertion were obeyed by 43% of ICUs and one-third of ICUs conduct regular screening of urine in catheterized patients. Urinary tract catheters are replaced at defined time intervals in 37% of ICUs. MRSA positive patients are not isolated in 5% of ICUs. MRSA screening on admission is not performed for high risk patients in 16% of ICUs.

Conclusions

There are still many German ICUs in which evidence-based recommendations are not implemented. Training of staff is necessary to improve quality of patient care.

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Authors and Affiliations

  1. Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule, Hannover

    R.-P. Vonberg & P. Gastmeier

  2. Institut für Hygiene und Umweltmedizin, Charité — Universitätsmedizin, Freie Universität und Humboldt Universität, Berlin

    K. Groneberg, C. Geffers & H. Rüden

  3. Nationales Referenzzentrum (NRZ) für die Surveillance nosokomialer Infektionen

    R.-P. Vonberg, K. Groneberg, C. Geffers, H. Rüden & P. Gastmeier

  4. Institut für Medizinische Mikrobiologie und Krankenhaushygiene, Medizinische Hochschule, Carl-Neuberg-Str. 1, 30625, Hannover

    R.-P. Vonberg

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  1. R.-P. Vonberg
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  2. K. Groneberg
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  3. C. Geffers
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Correspondence to R.-P. Vonberg.

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Vonberg, RP., Groneberg, K., Geffers, C. et al. Hygienemaßnahmen auf Intensivstationen. Anaesthesist 54, 975–982 (2005). https://doi.org/10.1007/s00101-005-0891-5

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  • DOI: https://doi.org/10.1007/s00101-005-0891-5

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