Creation of an External Ventricular Drain Registry from a Quality Improvement Project

Publication date: June 2018
Source:World Neurosurgery, Volume 114
Author(s): David P. Darrow, Coridon Quinn, Truong H. Do, Matthew Hunt, Stephen Haines
BackgroundExternal ventricular drains (EVDs) are a serious source of morbidity and mortality. Data for interventions proven to reduce risk of infections are lacking. Single-center studies are limited in studying procedures that mitigate infection, but bundled protocols have demonstrated utility. A collaborative EVD registry was designed to facilitate local quality improvement projects to be implemented at any location using standardized data collection instruments through resident collaboration to reduce and study EVD infection and prevention.MethodsA bundled protocol and comprehensive implementation program were developed as a quality improvement project to reduce ventriculostomy-associated infections. Standardized data collection forms were created for multi-institutional participation in an EVD registry. Retrospective and prospective patient data were documented in an electronic procedural registry, which was designed to capture variation among multiple institutions.ResultsTwo infections were found in 1924 EVD-days before protocol implementation; no infections were found in 700 EVD-days after protocol implementation. Baseline epidemiology of EVDs was calculated in preparation for comparison. A resident-driven EVD consortium, now with 5 other member institutions, was founded to collect data for an EVD registry fed by individual site quality improvement initiatives.ConclusionsThe ventriculostomy-associated infection rate at the University of Minnesota is low compared with the literature. Rationally bundled protocols have mounting evidence but do not allow for identifying effective individual components. Through the registry described here, others can join the EVD consortium to contribute data to facilitate comparative effectiveness research with minimal investment.



from #ORL-AlexandrosSfakianakis via ola Kala on Inoreader https://ift.tt/2pYbk3u