Effect of open vs closed ICU model on HAI

Editor's Note

A closed ICU model was associated with significantly reduced rates of central line associated blood stream infection (CLABSI), catheter associated urinary tract infection (CAUTI), and ventilator-associated pneumonia (VAP) in this study, presented May 22 at ATS 2019, the annual international conference of the American Thoracic Society in Dallas.

In a closed model, patients are evaluated and admitted by an intensivist and orders are written by the ICU team. In an open model, patients are evaluated and admitted by primary care physicians, with an intensivist following the patients as a consultant, and orders are written by the consultant.

There was a 19.3% reduction in CLABSI, 100% reduction in CAUTI, and 100% reduction in VAP rates using the closed ICU model.

There were no differences for rates of Clostridium difficile infection and methicillin-resistant Staphylococcus aureus blood infections between open and closed models.

The findings suggest that a closed ICU model is associated with significantly reduced rates of CLABSI, CAUTI, and VAP, the researchers say. They speculate that the systematic delivery of care under a single centralized leadership prevents infectious complications.