Impact of an Education Program on the Incidence of Central Line-Associated Bloodstream Infection in 2 Medical-Surgical Intensive Care Units in Brazil

2008 ◽  
Vol 29 (12) ◽  
pp. 1171-1173 ◽  
Author(s):  
Solange L. Santana ◽  
Guilherme H. C. Furtado ◽  
Sérgio Barsanti Wey ◽  
Eduardo A. S. Medeiros
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Education Program ◽  
Odds Ratio ◽  
Intervention Study ◽  
Central Line ◽  
Surgical Intensive Care ◽  
The Impact

An intervention study was undertaken to evaluate the impact of an education program on the incidence of central line–associated bloodstream infection (CLABSI) in 2 intensive care units. There was a nonsignificant reduction in the incidence of CLABSI (odds ratio, 0.46 [95% confidence interval, 0.21–1.02]; P = .04) despite a significant increase in knowledge of CLABSI prevention by the staff of both intensive care units after the education program.

Effect of Accounting for Multiple Concurrent Catheters on Central Line–Associated Bloodstream Infection Rates: Practical Data Supporting a Theoretical Concern

2011 ◽  
Vol 32 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Rebecca A. Aslakson ◽  
Mark Romig ◽  
Samuel M. Galvagno ◽  
Elizabeth Colantuoni ◽  
Sara E. Cosgrove ◽  
...  
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Conventional Method ◽  
Central Line ◽  
New Method ◽  
Surgical Intensive Care Unit ◽  
The Difference ◽  
Clabsi Rate

Background.Central line-associated bloodstream infection (CLABSI) rates are gaining importance as they become publicly reported metrics and potential pay-for-performance indicators. However, the current conventional method by which they are calculated may be misleading and unfairly penalize high-acuity care settings, where patients often have multiple consurrent central venous catheters (CVCs).Objective.We compared the conventional method of calculating CLABSI rates, in which the number of catheter-days is used (1 patient with n catheters for 1 day has 1 catheter-day), with a new method that accounts for multiple concurrent catheters (1 patient with n catheters for 1 day has n catheter-days), to determine whether the difference appreciably changes the estimated CLABSI rate.Design.Cross-sectional survey.Setting.Academic, tertiary care hospital.Patients.Adult patients who were consecutively admitted from June 10 through July 9, 2009, to a cardiac-surgical intensive care unit and a surgical intensive and surgical intermediate care unit.Results.Using the conventional method, we counted 485 catheter-days throughout the study period, with a daily mean of 18.6 catheter-days (95% confidence interval, 17.2-20.0 catheter-days) in the 2 intensive care units. In contrast, the new method identified 745 catheter-days, with a daily mean of 27.5 catheter-days (95% confidence interval, 25.6-30.3) in the 2 intensive care units. The difference was statistically significant (P < .001). The new method that accounted for multiple concurrent CVCs resulted in a 53.6% increase in the number of catheter-days; this increased denominator decreases the calculated CLABSI rate by 36%.Conclusions.The undercounting of catheter-days for patients with multiple concurrent CVCs that occurs when the conventional method of calculating CLABSI rates is used inflates the CLABSI rate for care settings that have a high CVC burden and may not adjust for underlying medical illness. Additional research is needed to validate and generalize our findings.

Impact of the International Nosocomial Infection Control Consortium (INICC)’s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in Argentina

2018 ◽  
Vol 39 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Victor Daniel Rosenthal ◽  
Javier Desse ◽  
Diego Marcelo Maurizi ◽  
Gustavo Jorge Chaparro ◽  
Pablo Wenceslao Orellano ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Density ◽  
Multidimensional Approach ◽  
The Impact ◽  
Clabsi Rate

OBJECTIVETo analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017.DESIGNThis prospective, pre–post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate.RESULTSDuring the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34–0.6; P<.001).CONCLUSIONSImplementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina.Infect Control Hosp Epidemiol 2018;39:445–451

scholarly journals Central Line–Associated Bloodstream Infection Reduction and Bundle Compliance in Intensive Care Units: A National Study

2016 ◽  
Vol 37 (7) ◽  
pp. 805-810 ◽  
Author(s):  
E. Yoko Furuya ◽  
Andrew W. Dick ◽  
Carolyn T. A. Herzig ◽  
Monika Pogorzelska-Maziarz ◽  
Elaine L. Larson ◽  
...  
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Infection Prevention ◽  
National Level ◽  
Central Line ◽  
National Study ◽  
Cross Sectional ◽  
Bundle Compliance ◽  
The Impact

OBJECTIVESTo describe compliance with the central line (CL) insertion bundle overall and with individual bundle elements in US adult intensive care units (ICUs) and to determine the relationship between bundle compliance and central line–associated bloodstream infection (CLABSI) rates.DESIGNCross-sectional study.PARTICIPANTSNational sample of adult ICUs participating in National Healthcare Safety Network (NHSN) surveillance.METHODSHospitals were surveyed to determine compliance with CL insertion bundle elements in ICUs. Corresponding NHSN ICU CLABSI rates were obtained. Multivariate Poisson regression models were used to assess associations between CL bundle compliance and CLABSI rates, controlling for hospital and ICU characteristics.RESULTSA total of 984 adult ICUs in 632 hospitals were included. Most ICUs had CL bundle policies, but only 69% reported excellent compliance (≥95%) with at least 1 element. Lower CLABSI rates were associated with compliance with just 1 element (incidence rate ratio [IRR] 0.77; 95% confidence interval [CI], 0.64–0.92); however, ≥95% compliance with all 5 elements was associated with the greatest reduction (IRR, 0.67; 95% CI, 0.59–0.77). There was no association between CLABSI rates and simply having a written CL bundle policy nor with bundle compliance <75%. Additionally, better-resourced infection prevention departments were associated with lower CLABSI rates.CONCLUSIONSOur findings demonstrate the impact of transferring infection prevention interventions to the real-world setting. Compliance with the entire bundle was most effective, although excellent compliance with even 1 bundle element was associated with lower CLABSI rates. The variability in compliance across ICUs suggests that, at the national level, there is still room for improvement in CLABSI reduction.Infect Control Hosp Epidemiol 2016;37:805–810

scholarly journals Impact of State Reporting Laws on Central Line-Associated Bloodstream Infection Rates in U.S. Adult Intensive Care Units

2016 ◽  
Vol 52 (3) ◽  
pp. 1079-1098 ◽  
Author(s):  
Hangsheng Liu ◽  
Carolyn T. A. Herzig ◽  
Andrew W. Dick ◽  
E. Yoko Furuya ◽  
Elaine Larson ◽  
...  
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Infection Rates ◽  
Reporting Laws

scholarly journals Surveillance Length and Validity of Benchmarks for Central Line-Associated Bloodstream Infection Incidence Rates in Intensive Care Units

PLoS ONE ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. e36582 ◽  
Author(s):  
Patricia S. Fontela ◽  
Caroline Quach ◽  
David Buckeridge ◽  
Madukhar Pai ◽  
Robert W. Platt
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Rates ◽  
Infection Incidence

The impact of formulary restriction on the relative consumption of carbapenems in intensive care units at an academic medical center

2019 ◽  
Vol 40 (9) ◽  
pp. 1056-1058
Author(s):  
Jacob W. Pierce ◽  
Andrew Kirk ◽  
Kimberly B. Lee ◽  
John D. Markley ◽  
Amy Pakyz ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Medical Center ◽  
Academic Medical Center ◽  
Interrupted Time Series ◽  
Interrupted Time Series Analysis ◽  
Surgical Intensive Care ◽  
Academic Medical ◽  
The Impact ◽  
Formulary Restriction

AbstractAntipseudomonal carbapenems are an important target for antimicrobial stewardship programs. We evaluated the impact of formulary restriction and preauthorization on relative carbapenem use for medical and surgical intensive care units at a large, urban academic medical center using interrupted time-series analysis.

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