Creation of an EVD Registry from a Quality Improvement Project.

Creation of an EVD Registry from a Quality Improvement Project.

World Neurosurg. 2018 Mar 12;:

Authors: Darrow DP, Quinn C, Donguyen HT, Hunt M, Haines S

Abstract
INTRODUCTION: External ventricular drains can pose a serious source of morbidity and mortality. Interventions proven to reduce the risk of infections are lacking. Single center studies limit the study of 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.
METHODS: A bundled protocol and comprehensive implementation program were developed as a quality improvement project to reduce ventriculostomy associated infections (VAI). 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 between multiple institutions.
RESULTS: Two infections were found in 1,924 EVD-days prior to protocol implementation, and 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 five other member institutions, was founded to collect data for an EVD registry fed by individual site quality improvement initiatives.
CONCLUSION: The rate of VAI at the University of Minnesota is low compared to 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.

PMID: 29545219 [PubMed - as supplied by publisher]

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