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    Hand Hygiene Compliance in Some Intensive Care Units of Turkey: Results of Multicentre Asklepeion Study
    (Galenos Yayincilik, 2018) Onal, Aye Uyan; Aksoy, Firdevs; Azak, Emel; Koc, Meliha Meric; Ceviker, Sevil Alkan; Hatipoglu, Cigdem Ataman; Gozukucuk, Ramazan; Sehmen, Emine; Ugurlu, Kenan; Senol, Gunes; Durmus, Gul; Mert, Habibe Tulin Elmaslar; Alay, Handan; Koc, Filiz; Caglayan, Derya; Dikis, Demet; Korkmaz, Nilay Bilgili; Kucuker, Nilgiin Deniz; Kepeli, Nurhayat; Ulusoy, Behiye; Barik, Sukran Askit; Pullukcu, Husnu; Sipahi, Hilal; Arda, Bilgin; Ulusoy, Sercan; Sipahi, Oguz Resat
    Introduction: Hand hygiene is one of the most cost-effective infection control measures. In this multicenter Study we analysed the hand hygiene compliance observation results of 15 hospitals in Turkey. Materials and Methods: This study was performed in intensive care units (ICUs) of 15 hospitals (Eight terriary-care educational hospitals, six state hospitals and one private hospital) from 11 cities from six regions of Turkey The observations were made by infection control practitioners according to the World Health Organization - Five Moments for Hand Hygiene (WHO-5) indications rule for hand hygiene and overall compliance rates were calculated. Observations were unblinded (healthcare professionals knew that they were observed). The study period included 2015 and 2016 calendar years. Results: There was a statistically significant increase in hand hygiene compliance rates in 2016 versus 2015. The overall number of hand hygiene indications and compliance in 2015 and 2016 were 60071/78116-76,9% and 66551/83607-79,6% (p=0.0001), respectively. Nurses were the most compliant group in both years. The highest compliance was in after body fluid exposure indication (88.2%-2015 and 91.4%-2016) while the lowest compliance was in before patient contact indication (61.3%-2015 and 65%-2016). Conclusion: The presented data suggest that under unblinded observations, hand hygiene compliance seems to be in relatively acceptable rates in Turkey. Centers with compliance rates below 50 percentile rates in any of the 5 moments should increase efforts to enhance compliance in that indication.
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    International Nosocomial Infection Control Consortium (INICC) national report on device-associated infection rates in 19 cities of Turkey, data summary for 2003-2012
    (Bmc, 2014) Leblebicioglu, Hakan; Erben, Nurettin; Rosenthal, Victor Daniel; Atasay, Begum; Erbay, Ayse; Unal, Serhat; Senol, Gunes; Willke, Ayse; Ozgultekin, Asu; Altin, Nilgun; Bakir, Mehmet; Oncul, Oral; Ersoz, Gulden; Ozdemir, Davut; Yalcin, Ata Nevzat; Ozdemir, Halil; Yildizdas, Dincer; Koksal, Iftihar; Aygun, Canan; Sirmatel, Fatma; Sener, Alper; Tuna, Nazan; Akan, OTzay Arikan; Turgut, Huseyin; Demiroz, A. Pekcan; Kendirli, Tanil; Alp, Emine; Uzun, Cengiz; Ulusoy, Sercan; Arman, Dilek; Ozgunes, Ilhan; Usluer, Gaye; Kilic, Atila; Arsan, Saadet; Cabadak, Hatice; Sen, Suha; Gelebek, Yasemin; Zengin, Humeyra; Topeli, Arzu; Alper, Yusuf; Meric, Meliha; Azak, Emel; Inan, Asuman; Turan, Guldem; Haznedaroglu, Tuncer; Gorenek, Levent; Acar, Ali; Cesur, Salih; Engin, Aynur; Kaya, Ali; Kuyucu, Necdet; Geyik, Mehmet Faruk; Aydin, Ozlem Cetinkaya; Erdogan, Nurse Selvi; Turhan, Ozge; Gunay, Nurgul; Gumus, Eylul; Dursun, Oguz; Esen, Saban; Ulger, Fatma; Dilek, Ahmet; Yilmaz, Hava; Sunbul, Mustafa; Gokmen, Zeynel; Ozdemir, Sonay Incesoy; Horoz, Ozden Ozgur; Yylmaz, Gurdal; Kaya, Selcuk; Ulusoy, Hulya; Kucukoduk, Sukru; Ustun, Cemal; Baysal, Abant Izzet; Otkun, Metin; Tulunay, Melek; Oral, Mehmet; Unal, Necmettin; Cengiz, Mustafa; Yilmaz, Leyla; Sacar, Suzan; Sungurtekin, Hulya; Ugurcan, Dogac; Yetkin, M. Arzu; Bulut, Cemal; Erdinc, F. Sebnem; Hatipoglu, Cigdem Ataman; Ince, Erdal; Ciftci, Ergin; Odek, Caglar; Yaman, Ayhan; Karbuz, Adem; Aldemir, Bilge; Kilic, Aysegul Ulu; Arda, Bilgin; Bacakoglu, Feza; Hizel, Kenan
    Background: Device-associated healthcare-acquired infections (DA-HAI) pose a threat to patient safety, particularly in the intensive care unit (ICU). We report the results of the International Infection Control Consortium (INICC) study conducted in Turkey from August 2003 through October 2012. Methods: A DA-HAI surveillance study in 63 adult, paediatric ICUs and neonatal ICUs (NICUs) from 29 hospitals, in 19 cities using the methods and definitions of the U.S. NHSN and INICC methods. Results: We collected prospective data from 94,498 ICU patients for 647,316 bed days. Pooled DA-HAI rates for adult and paediatric ICUs were 11.1 central line-associated bloodstream infections (CLABSIs) per 1000 central line (CL)-days, 21.4 ventilator-associated pneumonias (VAPs) per 1000 mechanical ventilator (MV)-days and 7.5 catheter-associated urinary tract infections (CAUTIs) per 1000 urinary catheter-days. Pooled DA-HAI rates for NICUs were 30 CLABSIs per 1000 CL-days, and 15.8 VAPs per 1000 MV-days. Extra length of stay (LOS) in adult and paediatric ICUs was 19.4 for CLABSI, 8.7 for VAP and 10.1 for CAUTI. Extra LOS in NICUs was 13.1 for patients with CLABSI and 16.2 for patients with VAP. Extra crude mortality was 12% for CLABSI, 19.4% for VAP and 10.5% for CAUTI in ICUs, and 15.4% for CLABSI and 10.5% for VAP in NICUs. Pooled device use (DU) ratios for adult and paediatric ICUs were 0.54 for MV, 0.65 for CL and 0.88 for UC, and 0.12 for MV, and 0.09 for CL in NICUs. The CLABSI rate was 8.5 per 1,000 CL days in the Medical Surgical ICUs included in this study, which is higher than the INICC report rate of 4.9, and more than eight times higher than the NHSN rate of 0.9. Similarly, the VAP and CAUTI rates were higher compared with U. S. NHSN (22.3 vs. 1.1 for VAP; 7.9 vs. 1.2 for CAUTI) and with the INICC report (22.3 vs. 16.5 in VAP; 7.9 vs. 5.3 in CAUTI). Conclusions: DA-HAI rates and DU ratios in our ICUs were higher than those reported in the INICC global report and in the US NHSN report.