Analysis of the Influence of Operating Room Nursing Care Management on the Incidence Rate of Nosocomial Infection in Orthopedic Surgery Patients

Objective:To analysis the influence of operating room nursing care management on the incidence rate of nosocomial infection in orthopedic surgery patients.Methodology:Fifty six orthopedic surgery patients who admitted into the hospital between January to December 2018 were enrolled into this study and randomly divided into two groups,which were the control group(under general management)and the observation group(under the operating room nursing care management).Further,the incidence rate of nosocomial infections,the incidence rate of irregular nursing care phenomena,the satisfaction score of nursing care management,and the quality of life score were observed and recorded.Result:The incidence rate of nosocomial infection,the incidence rate of irregular nursing care management,the satisfaction score of nursing care management,and the quality of life score of the observation group were compared to that of the control group,and the result showed P<0.05,indicates the statistical significance between the data indicators.Conclusion:The use of operating room nursing care management in patients with orthopedic surgery has shown a significant effect.

Effect of a program to control perioperative blood glucose on the incidence of nosocomial infections in patients with diabetes: A pilot study

Aim: To evaluate the safety and effectiveness of a pilot program to control perioperative blood glucose in patients with diabetes. Methods: A pre-post intervention study was conducted in a 280-bed hospital in Spain. In the year 2008 we implemented perioperative insulin protocols aimed at blood glucose values from 80 to 180 mg/dL. Surgical patients with diabetes admitted on year 2009 (intervention group) were compared with a control group of patients with diabetes admitted for surgery on year 2007, matched 1:1 by traditional wound class. Results: We analyzed 96 patients. Implemented protocols were followed in 48% of patients intra-operatively and 75% of patients postoperatively. Patients in the intervention group had reductions in blood glucose at surgery 150 +/- 61 mg/dL vs. 172 +/- 53 mg/dL;p = 0.05), greater proportion of target glucose values throughout hospitalization (67% vs. 55%;p = 0.07), and reductions in the incidence of nosocomial infections after controlling for confounders (Odds Ratio: 0.20;95% Confidence intervals: 0.06 - 0.72;p = 0.014) when they were compared with the control group: The incidence of hypoglycemia was similar between two groups (0.12% vs. 0.10%, p = 0.867), respectively. Conclusion: Although our protocol needs improvements to increase implementation it was useful to control blood glucose safely and for reducing nosocomial infections.

Risk Factors for Surgical Site Infections in Patients Operated at the University Clinic of Traumatology-Orthopedics and Restorative Surgery of the National Hospital and University Center Hubert Koutoukou Maga in Cotonou

Background: Operative site infections (ISO) are typically nosocomial. According to the WHO the incidence of ISO varies from 0.5% to 15% and exceeds 25% in developing countries. They result from the combined action of several factors and represent a concern for public health. To study the contributing factors of surgical site infections in patients operated at the University Clinic of Orthopedic Traumatology of CNHU-HKM of Cotonou. Method: This was an analytical cross-sectional study that involved 35 operated patients and ten nurses. Were included in our study: 1) All patients, without distinction of sex or age, having been operated on in the university clinic of orthopedic traumatology, during the survey period;2) Patients hospitalized for post-operative care during the survey period;3) The nursing staff on duty during our study period. The usual statistical measures were used according to the type of variables: means, standard deviations, percentages. Data analysis first involved calculating percentages for the qualitative variables and means followed by their standard deviations for the quantitative variables. Next, the Pearson Chi-square test was used to test the association between the dependent variable and the independent variables of interest. The significance level is set at p Results: The prevalence of surgical site infections was 28.58%. The main factors contributing to the occurrence of SSIs that were found were the patient’s level of education (p = 0.003) and the reuse of bandages used for dressing (p = 0.004). Other potential factors such as the economic status of the patient, the poor quality of technical dressings, and the preoperative stay were also highlighted. Conclusion: Surgical site infections remain a global concern. Risk factors were found on both the patient and nurse sides. It is urgent to address these various factors to minimize the occurrence of surgical site infections.

Urgent call for attention to diabetes-associated hospital infections

In this editorial,we discuss the recent article by Zhao et al published in the World Journal of Diabetes,which highlights the importance of recognizing the risk indicators associated with diabetes mellitus(DM).Given the severe implications of healthcare-associated infections(HAIs)in hospitalized individuals-such as heightened mortality rates,prolonged hospitalizations,and increased costs-we focus on elucidating the connection between DM and nosocomial infections.Diabetic patients are susceptible to pathogenic bacterial invasion and subsequent infection,with some already harboring co-infections upon admission.Notably,DM is an important risk factor for nosocomial urinary tract infections and surgical site infections,which may indirectly affect the occurrence of nosocomial bloodstream infections,especially in patients with DM with poor glycemic control.Although evidence regarding the impact of DM on healthcare-associated pneumonias remains inconclusive,attention to this potential association is warranted.Hospitalized patients with DM should prioritize meticulous blood glucose management,adherence to standard operating procedures,hand hygiene practices,environmental disinfection,and rational use of drugs during hospitalization.Further studies are imperative to explore the main risk factors of HAIs in patients with DM,enabling the development of preventative measures and mitigating the occurrence of HAIs in these patients.

Prevalence of hepatitis C infection among intravenous drug users in Shanghai

AIM:To characterize the prevalence of hepatitis C virus(HCV)infection among Chinese intravenous drug users(IDUs).METHODS:A total of 432 adult IDUs(95 women and337 men)in Shanghai were included in the study.The third-generation Elecsys Anti-HCV assay(Roche Diagnostics GmbH,Sandhofer Strasse 116,D-68305,Mannheim,Germany)was used to screen for antibodies against HCV.The RIBA strip,a supplemental antiHCV test with high specificity,was performed on all of the samples that tested positive during the initial screening.All of the anti-HCV positive samples were analyzed with a Cobas TaqMan 48 Analyzer(Roche Diagnostics)for direct detection of HCV RNA.All of the HCV RNA-positive samples were sequenced for genotype determination.RESULTS:The preliminary screening identified 262(60.6%)subjects who were seropositive for HCV.Of the 62 females and 200 males seropositive subjects,16(16.7%)and 65(19.3%),respectively,were confirmed by RIBA,yielding an overall HCV seropositive rate of18.8%.Four female(6.5%)and 14 male(7.0%)subjects tested positive for HCV RNA,indicating an active infection rate of 4.2%for the entire study population.The 18 HCV RNA-positive serum samples were genotyped.Seven individuals were genotype 1b,and four were genotype 1a.One individual each was infected with genotypes 2a,2b and 3a.Four subjects were coinfected with multiple strains:two with genotypes 1a and 2a,and two with genotypes 1b and 2a.The active infection rate among HCV-seropositive individuals was22.2%,which was significantly lower than most estimates.CONCLUSION:The prevalence of HCV is relatively low among IDUs in Shanghai,with a spontaneous recovery rate much higher than previous estimates.

Targeted montoring to surgical site infection and investigation of standard application of antibiotics during perioperative period

Objective To investigate current surgical site infection and perioperative antibiotics in inpatients and explore the controlling aim and methods. Methods The infection rates of surgical sites of 287 operated cases from May to Dec 31,2007 were studied and compared with

2016—2020年武汉市医院感染横断面调查结果趋势研究

目的 了解武汉市医疗机构医院感染和社区感染现状,分析医院感染的流行趋势与管理重点。方法 采用病历调查和床旁调查相结合的方法,按照全国医院感染监控管理培训基地制定的全国医院感染横断面调查表进行调查,分析2016、2018、2020年的调查数据。结果 2016、2018、2020年武汉市医院感染现患率分别为2.66%、2.21%、1.85%,社区感染现患率分别为17.81%、17.82%、16.29%,均呈下降趋势(均P<0.05)。医院感染现患率较高的科室为综合重症监护病房(ICU)、血液病科(组)、神经外科、胸外科、儿科新生儿组;社区感染现患率较高的科室为儿科非新生组、呼吸科(组)、感染病科(组)、综合ICU、儿科新生儿组。医院感染、社区感染感染部位均以下呼吸道为主,其中2016、2018、2020年术后下呼吸道医院感染构成比分别为12.85%、18.39%、22.09%。2016、2018、2020年手术部位医院感染现患率分别为0.99%、0.82%、0.69%。医院感染、社区感染病原体均以革兰阴性菌为主。结论 2016、2018、2020年武汉市医疗机构医院感染管理取得了较好的成效,但综合ICU、下呼吸道医院感染等问题仍需在后期工作中强化改进。

基于灰色GM(1,1)模型的我国医院感染患病率变化趋势及预测

目的了解我国医院感染患病率变化趋势,并采用灰色GM(1,1)模型对我国不同规模医院的医院感染患病率进行预测,为医院感染防控提供数据支持和新思路。方法采用描述性流行病学方法分析我国医院感染患病率变化趋势,2008—2016年我国医院感染患病率数据进行灰色GM(1,1)模型构建,2018—2020年数据进行模型验证。采用构建的灰色GM(1,1)模型对2022—2024年我国医院感染患病率进行预测。结果我国医院感染患病率呈下降趋势,随着医院规模的增加医院感染患病率升高。医院感染患病率灰色GM(1,1)模型的精度良好、拟合效果较高。2024年全国、<300张床位医院、300~599张床位医院、600~899张床位医院和≥900张床位医院的医院感染患病率可降为1.00%、0.49%、0.90%、1.13%和2.05%。结论我国医院感染防控效果明显,灰色GM(1,1)模型对我国医院感染患病率有较好的预测效果。

2020-2022年云南地区住院患者医院感染现患率调查

目的了解2020-2022年云南地区住院患者医院感染现状,为优化相应的防控措施提供参考资料。方法通过云南省医院感染质量控制中心监测系统收集2020-2022年云南地区医院感染现患率调查(横断面调查)上报的数据,汇总后应用SPSS 25.0软件进行统计分析。结果2020-2022年分别调查患者117695、109691、137188例,医院感染现患率分别为1.58%、1.47%、1.29%,差异有统计学意义(χ^(2)=36.853,P<0.001);感染部位以下呼吸道(2526例次,43.60%)和泌尿道(785例次,13.55%)为主;三次现患率调查综合重症监护病房(ICU)均是医院感染现患率最高的科室(10.95%~16.47%);医院感染病原体主要以革兰阴性菌为主,其中大肠埃希菌均居首位,肺炎克雷伯菌次之,而革兰阳性菌以金黄色葡萄球菌为主;患者抗菌药物使用率为30.96%~33.91%,呈上升趋势(χ^(2)=257.586,P<0.001);抗菌药物使用目的以治疗为主(占76.46%~78.62%);抗菌药物使用以一联用药为主,三联及以上用药略有升高,从0.66%上升至0.98%;治疗性使用抗菌药物病原学送检率呈上升趋势(χ^(2)=94.823,P<0.001)。Ⅰ类切口手术患者手术部位感染率为0.77%~1.22%,三年Ⅰ类切口手术患者抗菌药物预防性使用率分别为19.40%、19.11%、20.93%,差异均有统计学意义(χ^(2)值分别为94.823、10.179,均P=0.006)。结论云南地区住院患者医院感染现患率虽有所下降,但医院感染病原体的防控和Ⅰ类切口手术患者预防性抗菌药物的合理使用将是今后工作的重点和难点。

广西某老年病专科医院2013—2022年医院感染现患率调查结果分析

目的 调查广西某老年病专科医院2013-2022年医院感染现患率,并对结果进行分析。方法广西壮族自治区江滨医院2013-2022年每年开展医院感染调查,选择每年7月份某天0:00~24:00的所有临床住院患者为调查对象,包括调查当天出院及转院的患者,排除当日入院患者。回顾性分析各年度的医院感染监测管理资料并进行总结。结果 2013-2022年,在调查的11 078例患者中有223例发生医院感染,共234例次,总体医院感染现患率为2.01%(223/11 078),例次感染率为2.11%(234/11 078)。例次感染率以2014年最高,为3.72%,2021年最低,为1.14%,总体呈下降趋势。医院感染现患率最高的临床科室为呼吸内科(13.44%)。感染部位以下呼吸道为主,泌尿道、上呼吸道和胃肠道亦多见。本次调查的感染者共检出病原菌190株,其中革兰阴性菌135株(71.05%),革兰阳性菌44株(23.16%),真菌11株(5.79%)。多因素logistic回归分析结果显示,年龄≥65岁[OR(95%CI)=1.790(1.345~2.382),P<0.001]、使用抗生素[OR(95%CI)=1.912(1.445~2.530),P<0.001]是医院感染发生的独立危险因素(P<0.05)。结论 该医院的医院感染现患率呈下降趋势,防控工作取得一定成效,但还需针对重点科室、易发感染部位和高危人群加强管理。

PDCA循环法在提高抗菌药物治疗前病原学送检率中的临床实践

目的探讨PDCA循环法在提高住院患者抗菌药物治疗前病原学送检率中的应用效果。方法利用医院信息系统和杏林医院感染管理系统选取2021年1月至12月(PDCA管理前)以治疗为目的的全身性使用抗菌药物的住院患者37124例,使用特殊级抗菌药物的住院患者7837例,使用限制级抗菌药物的住院患者29493例,作为对照组;选取2022年1月至12月(PDCA管理后)的上述患者各26558例、7919例、24433例,作为观察组。运用PDCA循环法,通过调查现状、分析原因、制订计划、实施方案等步骤对抗菌药物治疗前病原学送检率进行全方位管理,比较管理前后住院患者抗菌药物治疗前病原学送检率的差异。结果观察组全身性抗菌药物、特殊级抗菌药物、限制级抗菌药物病原学送检率分别为60.86%,97.34%,89.50%,均显著高于对照组的56.61%,86.91%,64.29%(P<0.001)。结论PDCA循环法能有效提高住院患者抗菌药物治疗前病原学送检率。

某三级医院10年医院感染现患率变化趋势及多因素分析

目的描述某三级医院的医院感染现患率及相关因素在10年间的变化趋势,分析医院感染的影响因素。方法2013-2022年开展连续10年(每年选择一天作为调查日)的医院感染横断面调查并收集数据,采用趋势χ^(2)检验、Pearson相关系数对医院感染现患率和相关因素分布进行趋势分析,建立多因素logistic回归和多层感知器模型(multilayer perceptron,MLP)分析因素的独立效应和重要性。结果该医院2013-2022年医院感染现患率为4.66%~8.07%,呈线性上升趋势。ICU患者比例、调查日前近2 d内中心静脉导管的使用率呈线性上升趋势,而调查日前近2 d内留置导尿管的患者比例、近30 d内接受手术的患者比例下降。MLP显示医院感染患病前三位重要因素分别是住院时间>10 d、入住ICU和近2 d内留置中心静脉导管。多因素logistic回归模型表明,住院时间>10 d、调查日近2 d内留置中心静脉导管或导尿管、近30 d内手术史、入住ICU是医院感染的独立影响因子。结论该医院近10年来医院感染现患率呈线性上升趋势,应通过目标性监测进一步分析原因并确定干预方向。运用趋势检验统计分析方法和logistic回归、MLP等多因素模型,能进一步发掘医院感染现患率调查的数据价值。

外科手术患者手术部位感染现状分析及影响因素研究

目的 探讨外科手术患者手术部位感染(SSI)情况及其影响因素。方法 收集2020年1月至2021年12月于安徽省马鞍山市人民医院行外科手术的5 420例患者的临床资料,记录SSI及病原菌。根据患者SSI情况将其分为感染组(46例)与非感染组(5 374例)。比较两组临床资料,通过多因素logistic回归分析确定SSI的影响因素。结果 患者SSI发生率为0.85%(46/5 420)。分离出的48株病原菌中革兰氏阴性菌31株(64.58%),革兰氏阳性菌17株(35.42%)。感染组年龄>65岁、合并糖尿病、全身麻醉、切口类型Ⅲ类、急诊手术、美国麻醉医师协会分级Ⅲ级、术前使用抗菌药物者占比均高于非感染组,手术时间、住院时间均长于非感染组,差异有统计学意义(P<0.05)。影响因素分析显示,年龄(OR=2.125,95%CI:1.104~4.090)、合并糖尿病(OR=2.585,95%CI:1.327~5.036)、手术时机(OR=2.209,95%CI:1.306~3.736)、手术时间(OR=2.704,95%CI:1.325~5.518)、住院时间(OR=2.767,95%CI:1.348~5.680)、切口类型(OR=2.159,95%CI:1.128~4.325)、术前抗菌药物使用情况(OR=0.784,95%CI:0.673~0.995)是外科手术患者SSI的影响因素(P<0.05)。结论 年龄、糖尿病、手术时机、手术时间、住院时间、切口类型、术前抗菌药物使用是外科手术患者SSI的影响因素,针对上述因素予以早期干预有利于减少SSI。

基于项目化管理模式以提高医院感染诊断相关病原学送检率的应用研究

目的调查某院医院感染诊断相关病原学送检情况,采取项目化管理模式以提高医院感染诊断相关病原学送检率。方法选取重庆市某三级甲等医院2022年1月—12月医院感染病例送检情况为对照组,2023年1月—12月医院感染病例送检情况为干预组,比较两组医院感染诊断相关病原学送检率、微生物标本不合格率及无菌性标本构成比的差异。结果干预组医院感染诊断相关病原学送检率(90.32%)高于对照组(82.77%),微生物标本不合格率(0.98%)较对照组(1.33%)下降,无菌性标本构成比(40.66%)高于对照组(37.75%),差异均具有统计学意义(P<0.05)。结论项目化管理模式可有效提升医院感染诊断相关病原学送检率及微生物标本送检质量,但未来还需进一步加强信息化建设。

妇科节育手术后感染发生率及其流行趋势探讨

目的:了解目前我国妇科节育手术后感染发生率和流行趋势。方法:利用2007-2020年我国卫生统计年鉴监测的大数据资料,计算放(取)宫内节育器(IUD)、输卵管绝育术、人工流产等节育手术后感染发生率。采用Joinpoint回归模型,计算年度变化百分比(APC)和平均年度变化百分比(AAPC)估计值,对感染率进行趋势分析。结果:从2018-2020年年鉴公布数据来看,目前我国人工流产、输卵管结扎及放(取)IUD手术后感染率分别约为7.3/10万、5.6/10万和5.6/10万,3种手术总体感染率为6.6/10万。从2007-2020年,我国妇科节育手术后总体感染率、放(取)IUD手术后感染率和人工流产手术后感染率均呈不断降低的趋势,AAPC分别为-10.9%、-9.9%和-7.2%(P均<0.05)。总体上2007-2020年输卵管结扎术后感染率呈下降趋势(AAPC=-14.4,P<0.05),但这种下降趋势仅在2007-2012年有统计学意义(APC=-9.5,P<0.05)。结论:我国在妇科节育手术后感染防控方面取得显著成效,妇科节育手术后感染率较低,但节育手术后感染率随访、监测工作依然困难,值得进一步关注与研究。

某教学医院连续三年医院感染现患率调查分析

目的了解陕西省某三甲教学医院的医院感染状况,为有效预防与控制医院感染提供数据支持。方法按照陕西省中医系统医院感染管理质控中心要求,采用横断面调查的方法,于2016—2018年对该院住院患者医院感染现患率进行调查与分析。结果2016—2018年共调查4961例住院患者。2016—2018年医院感染现患率分别为1.82%、1.25%、1.68%。医院感染部位以下呼吸道为主,其次为泌尿道与上呼吸道感染。病原体分布以鲍曼不动杆菌、肺炎克雷伯菌以及大肠埃希菌为主。结论该三甲教学医院的医院感染现患率与全国平均水平基本一致,但高于西安地区,提示应该采取行动加强医院感染预防与控制。

胸腺肽对住院精神分裂症患者炎症指标及院内感染率的影响

目的探究胸腺肽对住院精神分裂症患者免疫炎症指标及院内感染率的影响。方法以100例精神分裂症患者作为研究对象,用随机数字表法分为对照组和观察组,每组50例。对照组给予常规抗精神病药物治疗,观察组在对照组治疗的基础上口服胸腺肽肠溶片,2组均连续治疗1个月。比较2组的免疫炎症指标、院内感染率以及精神分裂症患者生活质量量表(schizophrenia quality of life scale,SQLS)评分,统计2组不良反应的发生情况。结果治疗后,2组患者的CD3^(+)、CD4^(+)、CD8^(+)均升高,且观察组均高于对照组(P<0.05),2组的CD4^(+)/CD8^(+)比较差异无统计学意义(P>0.05);2组血清白细胞介素-6(interleukin-6,IL-6)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)及碱性成纤维细胞生长因子(basic fibroblast growth factor,b-FGF)水平均下降,且观察组均低于对照组(P<0.05);观察组的医院感染率(2.00%)显著低于对照组(14.00%),P<0.05;治疗后,2组的SQLS各维度评分及总分均降低,且观察组均低于对照组(P<0.05);2组的不良反应总发生率比较差异无统计学意义(P>0.05)。结论住院精神分裂症患者应用胸腺肽治疗,可有效改善免疫炎症指标,降低医院感染率,提高患者的生活质量。

颅脑术后院内感染患者感染部位、病原菌分布特点及潜在影响因素分析

目的探讨颅脑外科手术后发生院内感染患者的感染部位、病原菌分布特点及发生感染的危险因素。方法采取病例对照研究方案,选取苏州市中西医结合医院2018年1月至2021年12月颅脑外科手术治疗后发生院内感染的患者80例[年龄(63.2±8.2)岁]作为感染组,同期实施颅脑外科手术但是未发生院内感染的患者80例[年龄(61.7±7.8)岁]作为对照组,查阅2组患者的病案、实验室检查资料,分析颅脑手术后并发院内感染患者的感染部位分布、病原菌特点,并采用单因素和多因素分析探讨引起颅脑外科手术后发生院内感染的危险因素。结果80例颅脑手术后发生院内感染的患者,主要为呼吸系统感染(58.75%),其次为泌尿系统感染(22.50%)。呼吸系统、泌尿系统、神经系统感染患者的病原菌类型均以革兰氏阴性菌为主,血液系统感染患者的病原菌中革兰氏阴性菌和阳性菌各占50%,不同部位感染患者的病原菌类型构成情况比较,差异无统计学意义(P>0.05)。在51例革兰氏阴性菌感染的患者中,主要为大肠埃希菌(26.25%)、鲍曼不动杆菌(15.00%)感染;29例革兰氏阳性菌感染患者中,主要为金黄色葡萄球菌(16.25%)、粪肠球菌(11.25%)感染。Logistic回归模型结果显示:非Ⅰ类切口、脑室外引流、脑脊液外漏、术前未预防性使用抗生素、留置导尿管是颅脑外科手术患者术后发生院内感染的独立危险因素(P<0.05)。结论颅脑外科手术后发生院内感染患者主要以呼吸系统、泌尿系统感染为主,病原菌类型主要为革兰氏阴性菌、非Ⅰ类切口、脑室外引流、脑脊液外漏、术前未预防性使用抗生素、留置导尿管可能会增大患者术后发生院内感染的风险。

某妇幼专科医院2019—2021年病原菌分布及耐药性分析

目的 了解某妇幼专科医院病原菌检出分布、耐药情况及重点监测多重耐药菌检出及感染发生情况,为临床合理使用抗菌药物及医院感染有效防控提供依据。方法 通过医院感染实施监控系统,对2019年1月—2021年12月住院患者病原菌检出分布、重点监测多重耐药菌分布及主要检出病原菌药敏情况进行回顾性调查。结果 2019年1月—2021年12月,该院共检出病原菌12 161株,革兰氏阳性菌5 860株(48.19%),革兰氏阴性菌5 351株(44.00%),真菌950株(7.81%)。标本来源主要是痰液,共分离5 979株(49.17%);耐甲氧西林金黄色葡萄球菌(Methicillin-resistant staphylococcus aureus,MRSA)检出率最高,达到48.16%;PICU多重耐药菌医院感染例次率最高,为0.20%。金黄色葡萄球菌及表皮葡萄球菌对青霉素及阿莫西林的耐药率均超过90%;肺炎链球菌对红霉素、四环素等耐药率高;流感嗜血杆菌对氨苄西林、氨苄西林舒巴坦耐药率较高;大肠埃希菌及肺炎克雷伯菌对头孢唑林、头孢哌酮、氨苄西林、阿莫西林的耐药率高。主要检出真菌对两性霉素B及氟胞嘧啶敏感性较好。结论 要进一步加强抗菌药物使用前病原学送检率及耐药性监测,合理使用抗菌药物,强化多重耐药菌感染预防控制工作,保证患者及医疗安全。

Healthcare Quality According to ICU Level of Care

Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1st January 2017 and 31st December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differences in quality of care provided by Level 1 and Level 2 ICUs in Poland, although more rigorous adhesion to admission and discharge policies is needed. Implementation of the instruments for assessing quality of ICUs including benchmarking, self-assessment of departments and evaluation of changes resulting from audits according to the Deming cycle is of utmost importance. Standardization of quality measures and markers, communication, and cooperation in reporting and creation of ICU medical registers is necessary to improve the quality of healthcare.