Abstract
![CDATA[Background: HAI and sepsis pose a threat to patient safety. Patients presenting following a traumatic injury have an increased susceptibility to HAI and sepsis leading to unfavourable morbidity and mortality outcomes. Aim: The aim of this integrative literature review was to explore the evidence to identify risk factors that predict HAI or sepsis in patients following admission for traumatic injury. Methods: Medline and Scopus were electronically searched from 2007 to 2018 and key journals were hand-searched. Ancestry searching was also performed. Study criteria included: (1) quantitative studies, qualitative and mixed-methods papers, (2) sample populations of patients admitted to hospital following traumatic injury who developed at least one HAI over the course of their hospitalisation and (3) articles that were written in English. Each study was evaluated independently by two authors using the Critical Appraisal Skills Program checklists. Data extraction was completed by one author. Findings: 7 articles (1 case control and 6 cohort studies) of ‘fair-moderate’ to ‘good’ quality were included in final review. Patient factors included (1) age (OR 1.29, 1.15-1.43), (2) deranged physiology (OR 1.66, 1.50-1.84), (3) frailty (p = 0.005, OR 1.46, 95% CI 2.28-38.78), (4) aspiration (p = 0.004, OR 33.86, 95% CI 3.10-370.07) and (5) oral colonization (p = 0.02, OR 9.41, 95% CI 2.28-38.78). System factors included major surgical intervention (OR 1.71, 1.46-2.00) and ICU admission (OR 10.75, 8.19-14.11). Conclusions: Findings were inconclusive due to limited good quality studies. There is an overt focus on patient-related risk factors rather than healthcare providers or system factors. Furthermore, studies identified did not reflect contemporary infection prevention strategies, in particular the impact of early implementation of care bundles in Emergency Departments. Implications: Patient outcomes in relation to HAI and sepsis must be improved. Research into provider and system factors is urgently needed.]]
Original language | English |
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Title of host publication | 16th International Conference for Emergency Nursing (ICEN18): Showcasing the Best of Emergency Care, 10-12 October, 2018, Pullman Albert Park, Melbourne |
Publisher | College of Emergency Nursing Australasia |
Number of pages | 1 |
Publication status | Published - 2018 |
Event | International Conference for Emergency Nursing - Duration: 1 Jan 2018 → … |
Conference
Conference | International Conference for Emergency Nursing |
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Period | 1/01/18 → … |
Keywords
- septicemia
- patients