Healthcare Acquired Infection Risk and Toothbrush Contamination in the ICU.

摘要: HEALTHCARE ACQUIRED INFECTION RISK AND TOOTHBRUSH CONTAMINATION IN THE ICU. By Michelle R. Frazelle, RN, MSN, CCRN A dissertation submitted in partial fulfillment of the requirements for degree Doctor Philosophy at Virginia Commonwealth University. University, 2011 VCU Chair: Mary Jo Grap, PhD, FAAN Professor, Adult Health and Nursing Systems School NIH/NINR NRSA Cindy L. Munro, Associate Dean, University South Florida, Hospital acquired infections (HAIs) are a complex multi-factorial problem associated with high morbidity, mortality, cost. Toothbrushes (TBs) may be risk contamination potential pathogenic microorganisms (PPMs) from patient care environment or autoinoculation patient. We focused on three PPMs: methicillin resistant Staphylococcus aureus (MRSA), vancomycin Enterococcus spp. (VRE), Acinetobacter Specific aims were to (1) describe environmental factors TB ICU (2) relationship between oral colonization critically ill adults. cross-sectional design was used examine physical which TBs found as well microbial flora 100 paired samples (subjects their TBs) over 72 hour period (at 24, 48 hours). Concordance among cultures determined by genetic typing. Data analyzed linear logistic regression, chi-square analysis, Fisher’s exact test ANOVA. Fourteen contaminated; 1 had more than one PPM species. Contamination occurred all time points. All but contaminated located nursing cart; cart drawers highest recovery rates PPMs. Toothbrush increased distance bathroom increased. sink decreased. Ten contact some type article. There significant association presence use storage container. The toothbrush weight (moisture debris) contamination. Baseline PPMs 19% while repeat 20%. that became 3 PPMs; might act fomites increase infection ill. Additional research linking outcomes is critical understanding level risk. Nurses should carefully consider handling TBs. closed drawer other items not ideal.