The EURO.NIS Concerted Action provides the opportunity of creating a large network of research groups and hospital wards in 14 European countries. This network aims at the promotion of collaborative research and the improvement of the prevention of nosocomial infections in European hospitals.
The European nosocomial infection survey (EURO.NIS) Concerted Action provided the opportunity of creating a large network of research groups and hospital wards in 14 European countries. This network will promote collaborative research and improve the prevention of nosocomial infections in European hospitals.
During the period of 1990 to 1992, the group carried out 2 large surveys, one in 1005 intensive care units (ICU) on their usual infection prevention practices, the other in 325 ICUs which followed 9127 patients using a standardized procedure to measure the frequency of nosocomial pneumonias. The determinants and consequences were analysed.
The 2 studies have made obvious the variability of the situation in European hospitals with respect to:
the functioning of each ICU and the resources available to them;
the organization of the prevention of nosocomial infections and techniques used;
the level of risk infection and the associated factors.
The results constitute a basis for current preventive activities, involving the drawing up of a reference book and of documents to be diffused in the specialized press, and then the preparation of technical guidelines as well as the corresponding educational programmes.
The specific objectives of the EURO.NIS Concerted Action were:
A) To assess the level and nature of variability in health care practices related to NI occurrence, costs and prevention within ICU's in participating European Countries:
- physical facilities and staffing
- epidemiologic surveillance of infection
- health care activities related to the prevention of NI
- antibiotic policy
- general procedure for infection control (isolation)
This first objective of the Concerted Action focused on the dissemination of previously validated preventive measures and health care technologies (as those described in the CDC Guidelines).
B) To undertake a detailed analysis of the situation of nosocomial pneumonia with regard to incidence, lethality, predictive factors, associated medical extra-costs and relative efficiency of the various prophylactic methods:
- crude incidence of nosocomial pneumonia according to the patient's characteristics and the care delivered;
- clinical and microbiological characteristics of nosocomial pneumonia;
- risk factors associated with the occurrence of pneumonia and estimates of their specific impact;
- level of lethality of nosocomial pneumonia;
- role of nosocomial pneumonia as a risk factor for mortality in ICU patients;
- role of nosocomial pneumonia in increasing the length of the stay;
- cost of antibiotic treatment of nosocomial pneumonia.
This second objective of the Concerted Action would provide reference data on nosocomial pneumonia rates in different countries and types of ICU's, using common criteria and definitions.