Trends in device utilization ratios in intensive care units over 10-year period in South Korea: device utilization ratio as a new aspect of surveillance

Abstract

Device-associated infection (DAI) is an important issue related to patient safety. It is important to reduce unnecessary device utilization in order to decrease DAI rates. To investigate the time trend of device utilization ratios (DURs) of voluntarily participating hospitals, collected over a 10-year period through the Korean National Healthcare-associated Infections Surveillance System (KONIS). DURs from 2006 to 2015 in 190 intensive care units (ICUs) participating in KONIS were included in this study. DURs were calculated as the ratio of device-days to patient-days. The pooled incidences of DAIs and DURs were calculated for each year of participation, and the year-wise trends were analysed. Year-wise ventilator utilization ratio (V-DUR) increased significantly from 0.40 to 0.41 (F=6.27, P<0.01), urinary catheter utilization ratio (U-DUR) increased non-significantly from 0.83 to 0.84 (F=1.66, P=0.10), and C-line utilization ratio (CL-DUR) decreased non-significantly from 0.55 to 0.51 (F=1.62, P=0.11). In the subgroup analysis, 'medical ICU' (F=2.79, P<0.01) and 'hospital with >900 beds' (F=3.07, P<0.01) were associated with the significant increase in V-DUR. In Korea, V-DUR showed a significant, year-wise increasing trend. The trends for U-DUR and CL-DUR showed no significant decrease. Efforts are required to ensure the reduction of DURs.