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A Multidisciplinary Approach to End External Ventricular Drain Infections in the Neurocritical Care Unit

Hill, Michelle; Baker, Glenna; Carter, Deneen; Henman, Lita Jo; Marshall, Kristi; Mohn, Kristina; Moody, Elizabeth

Journal of Neuroscience Nursing: August 2012 - Volume 44 - Issue 4 - p 188–193
doi: 10.1097/JNN.0b013e3182527672
Article

ABSTRACT: External ventricular drain (EVD) placement is a common practice in neurocritical care units. The EVDs are the “gold” standard and the most cost-effective treatment for intracranial hypertension and hydrocephalus caused by a variety of neurological conditions. The EVD drains excess cerebrospinal fluid in an attempt to maintain balance within the cranial vault and provides intermittent monitoring of intracranial pressure. This invasive procedure, as with any other procedures, carries an increased risk of a device-related infection that can lead to devastating consequences such as meningitis, ventriculitis, and death. This article will discuss how Riverside Methodist Hospital, which is located in Central Ohio, identified an increase in the rate of EVD infections in 2007 and responded with changes in procedure and processes. The implementation of the improvement plan has resulted in 25 months without an EVD infection, a triumph for the patients, staff, and the hospital system.

Questions or comments about this article may be directed to Michelle Hill, RN BSN CNRN CCRN, at mhill4@ohiohealth.com. She is a clinical educator, Riverside Methodist Hospital, Columbus, OH.

Glenna Baker, MSN CNP, is a neurosurgery nurse practitioner, Riverside Methodist Hospital, Columbus, OH.

Deneen Carter, RN, is a staff RN, Riverside Methodist Hospital, Columbus, OH.

Lita Jo Henman, MPH CIC, is the infection control manager, Riverside Methodist Hospital, Columbus, OH.

Kristi Marshall, RN, is the nurse manager, Riverside Methodist Hospital, Columbus, OH.

Kristina Mohn, RN BSN, is a staff RN, Riverside Methodist Hospital, Columbus, OH.

Elizabeth Moody, RN BSN, is a staff RN, Riverside Methodist Hospital, Columbus, OH.

The authors declare no conflicts of interest.

© 2012 American Association of Neuroscience Nurses