Background: External ventricular drain (EVD)-associated infections have a negative impact on healthcare cost and patient outcomes. Practice variation in EVD management may place patients at increased risk for EVD-associated infection. This project aimed to evaluate the impact of implementing an interprofessional evidence-based EVD bundle of care on reduction of EVD-related ventriculitis rates.
Methods: An interprofessional team developed an evidence based EVD care bundle and order set to eliminate practice inconsistencies. Standardization of EVD equipment and optimization of the electronic health record occurred. Education and competency validation were completed with neurosurgical providers and nurses. Interprofessional rounds occur weekly for observation, recognition, and in-the-moment education.
Results: A pre/post intervention design was used to show that the rate of EVD-associated ventriculitis decreased from 8.8 per reported EVD days in 2019 to 0 per reported EVD days in 2021 after implementation of the EVD care bundle.
Conclusion: Through an interprofessional team approach, reduction in EVD-associated infection rates is feasible with implementation of an evidence based EVD care bundle.
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http://dx.doi.org/10.1016/j.ajic.2022.08.029 | DOI Listing |
World Neurosurg
January 2025
Department of Neurosurgery, Emory University School of Medicine, 1365 Clifton Road NE, Ste. B6200, Atlanta, Georgia, USA 30322; Radiology and Imaging Sciences, Division of Interventional Neuroradiology, Emory University School of Medicine, 1364 Clifton Road NE, AG26, Atlanta, Georgia, USA, 30322.
Background: Aneurysmal subarachnoid hemorrhage (aSAH) is frequently complicated by permanent shunt-dependent hydrocephalus, but it is difficult to predict which patients are at highest risk.
Objective: This study seeks to identify novel variables associated with shunt dependency after aSAH and to create a predictive algorithm that improves upon existing models.
Methods: Retrospective case control design was used.
J Neurosurg
January 2025
Departments of1Neurosurgery.
Objective: Intraventricular hemorrhage (IVH) is a serious condition with high mortality rates and poor functional outcome in survivors. Treatment includes external ventricular drains (EVDs), which are associated with several complications. This study reports the clinical outcome and complication rate in patients with primary IVH (pIVH) and secondary IVH treated with EVDs.
View Article and Find Full Text PDFJ Neurosurg Anesthesiol
January 2025
Neurological Surgery.
Background: We implemented a quality improvement project to transition from routine cerebrospinal fluid (CSF) sampling to indication-based sampling in aneurysmal subarachnoid hemorrhage (aSAH) patients with an external ventricular drain (EVD).
Methods: Forty-seven patients were assessed across 2 epochs: routine (n=22) and indication-based (n=25) CSF sampling. The primary outcome was the number of CSF samples, and secondary outcomes included cost reductions and ventriculostomy-associated infections.
Cureus
November 2024
Anesthesiology and Pain Medicine, Harborview Medical Center, Seattle, USA.
Patient Saf Surg
December 2024
Division of Neurosurgery, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Background: External ventricular drain (EVD) insertion is one of the most commonly performed neurosurgical procedures. Herein, we introduce a new concept of a cranial fixation device for insertion of EVDs, that reduces reliance on freehand placement and drilling techniques and provides a simple, minimally invasive approach that provides strong fixation to minimal thickness skulls.
Methods: An experimental device for catheter insertion and fixation was designed and tested in both ex-vivo and in-vivo conditions to assess accurate cannulation of the ventricle and to test the strength of fixation to the skull.
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