EFFECT OF STANDARDIZATION OF NURSING CARES ON INCIDENCE OF NOSOCOMIAL INFECTION IN MICU.

Nosocomial infection is an important concern in intensive care units (ICUs) and associated with an increase in mortality, length of stay, and costs of hospitalization. Unfortunately incidence rate of these infections in our country are more than the rates in developed countries. Theoretically one of the most important reasons for this problem is poor quality of nursing care. The aim of this study is improving quality of cares and evaluation of its effects on incidence of nosocomial infections in MICU.

Materials & Methods: This is an action research conducted in four steps and lasted one year. At first we collected baseline data of nosocomial infections. In the second step, we designed an action plan to make necessary changes in nursing cares delivered to patients, stundardized nurse-patient ratio, and educated the staff. In third step, we carried out the action plan and finally in the fourth step we compared the results of final stage with baseline data. 64 patients at first stage and 86 patients later in the third step were selected as subjects using purposive sampling approach. In order to control the unwanted variables, we focused on 11 diagnostic groups and the age of more than 16. Furthermore, we controlled severity of disease in each diagnostic group using APACHE II in the first and the third steps. Multiple data gathering methods were used including questionnaires, Lab tests results, field and especialists note. A descriptive analysis using SPSS 12 was performed. Continuous variables were expressed as means ± SD. Associations between frequencies were assessed with the Fisher’s exact test. Statistical significance was defined as p<0.05 .

Results: Results showed that implementaing standard nursing care plan led to improve almost all aspects of the critical care outcomes. There was a dramatic reduction in rates of nosocomial infections. Rate of VAP, UTI, and pneumonia decreased from 17.18%, 9.37%, and 1.85%, to 3.48%, 3.48%, and 0%, respectively.�

Conclusion: This study highlights the importance of implementing standards on reducing nosocomial infections rate in MICUs