The aim of our study is to reduce the incidence of External ventricular drain (EVD)-related infections by implementing a bundle of measures including updated care protocoles and training of residents, nurses and nurses assistants. At Nice University Hospital, we are conducting a retrospective study showing a 22% infection rate associated with EVD. The identified pathogens are mainly transmitted by manual contact. Additionnally, high turnover among paramedical staff and sometimes rapid training may contribute to infection ocurrence. We hypothesize that a significant proportion of patients with EVD develop nosocomial ventriculitis, primarily due to modificable risk factors such as catheter handling and breaches in aseptic technique.
Age ≥ 18 years.
Hospitalized in a general intensive care unit or intermediate care unit at Nice University Hospital.
Having undergone EVD placement within the institution.
EVD placed outside the institution with no possibility of follow-up.
Patient under immediate therapeutic limitation.
Pre-existing neuromeningeal infection.
Expression by the patient or by the trusted person of opposition to the processing of the patient's medical data.
The study population consists of adult patients admitted to the general intensive care and intermediate care units of Nice University Hospital who underwent EVD placement on site.
Cohort
Other
Bundle of measures including updated care protocoles and training of residents, nurses and nurses assistants
Other interventionPreventive measures are structured around several key areas : updating the EVD insertion protocol and the EVD care protocol, optimizing dressing changes and scalp cleansing ; ; creation of reminder signage displayed outside the rooms of patients with an EVD outlining key hygiene rules ; implementation of theoretical teaching and simulation sessions for residents and nurses, covering EVD management, infectious complications, their treatment, and prevention ; assessment through a questionnaire on EVD management before implementation of preventive measures and after.
Occurrence of an infection related to EVDs between the day of insertion and up to 30 daysafterward.
Number of infections according to the 2017. Altération de la biochimie du LCR. Clinical deterioration of the patient
Occurrence of a contamination related to EVDs
Number of contamination according to : CSF with a single positive culture or a direct examination with Gram staining showing a microorganism, without any alteration in CSF biochemistry and without clinical deterioration. CSF contamination corresponds to the detection of microorganisms in a CSF sample that do not originate from the site being studied (CSF).
Occurrence of a colonisation related to EVDs
Number of colonisation according to CSF with multiple positive cultures or multiple direct examinations with Gram staining showing a microorganism, without any alteration in CSF biochemistry and without clinical deterioration. CSF colonization corresponds to the presence of microorganisms in the CSF without any associated clinical manifestations.
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