scholarly journals Comparison of Total Hospital-Acquired Bloodstream Infections to Central Line–Associated Bloodstream Infections and Implications for Outcome Measures in Infection Control

2013 ◽  
Vol 34 (9) ◽  
pp. 984-986 ◽  
Author(s):  
Surbhi Leekha ◽  
Shanshan Li ◽  
Kerri A. Thom ◽  
Michael Anne Preas ◽  
Brian S. Caffo ◽  
...  
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Outcome Measures ◽  
Bloodstream Infections ◽  
Central Line ◽  
Total Hospital ◽  
Prevention Intervention ◽  
Hospital Acquired

The validity of the central line-associated bloodstream infection (CLABSI) measure is compromised by subjectivity. We observed significant decreases in both CLABSIs and total hospital-acquired bloodstream infections (BSIs) following a CLABSI prevention intervention in adult intensive care units. Total hospital-acquired BSIs could be explored as an adjunct, objective CLABSI measure.

Impact of International Nosocomial Infection Control Consortium’s multidimensional approach on central line–associated bloodstream infection rates in Bahrain

2019 ◽  
Vol 21 (4) ◽  
pp. 481-489
Author(s):  
Safaa Alkhawaja ◽  
Nermeen Kamal Saeed ◽  
Victor Daniel Rosenthal ◽  
Sana Abdul-Aziz ◽  
Ameena Alsayegh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Infection Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Multidimensional Approach ◽  
Infection Rates

Background: Central line–associated bloodstream infections are serious life-threatening infections in the intensive care unit setting. Methods: To analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line–associated bloodstream infection rates in Bahrain from January 2013 to December 2016, we conducted a prospective, before-after surveillance, cohort, observational study in one intensive care unit in Bahrain. During baseline, we performed outcome and process surveillance of central line–associated bloodstream infection on 2320 intensive care unit patients, applying Centers for Disease Control and Prevention’s National Healthcare Safety Network definitions. During intervention, we implemented IMA through ISOS, including (1) a bundle of infection prevention interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on central line–associated bloodstream infection 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 central line–associated bloodstream infection rate. Results: During baseline, 672 central line days and 7 central line–associated bloodstream infections were recorded, accounting for 10.4 central line–associated bloodstream infections per 1000 central line days. During intervention, 13,020 central line days and 48 central line–associated bloodstream infections were recorded. After the second year, there was a sustained 89% cumulative central line–associated bloodstream infection rate reduction to 1.2 central line–associated bloodstream infections per 1000 central line days (incidence density rate, 0.11; 95% confidence interval 0.1–0.3; p, 0.001). The average extra length of stay of patients with central line–associated bloodstream infection was 23.3 days, and due to the reduction of central line–associated bloodstream infections, 367 days of hospitalization were saved, amounting to a reduction in hospitalization costs of US$1,100,553. Conclusion: Implementing IMA was associated with a significant reduction in the central line–associated bloodstream infection rate in Bahrain.

Modern Trends in Infection Control Practices in Intensive Care Units

2013 ◽  
Vol 29 (6) ◽  
pp. 311-326 ◽  
Author(s):  
Sumanth Gandra ◽  
Richard T. Ellison
Keyword(s):  
Intensive Care ◽  
Infection Control ◽  
Infection Prevention ◽  
Bloodstream Infections ◽  
Central Line ◽  
Environmental Cleaning ◽  
Hospital Acquired Infections ◽  
New Methods ◽  
Tract Infections ◽  
Hospital Acquired

Hospital-acquired infections (HAIs) are common in intensive care unit (ICU) patients and are associated with increased morbidity and mortality. There has been an increasing effort to prevent HAIs, and infection control practices are paramount in avoiding these complications. In the last several years, numerous developments have been seen in the infection prevention strategies in various health care settings. This article reviews the modern trends in infection control practices to prevent HAIs in ICUs with a focus on methods for monitoring hand hygiene, updates in isolation precautions, new methods for environmental cleaning, antimicrobial bathing, prevention of ventilator-associated pneumonia, central line-associated bloodstream infections, catheter-associated urinary tract infections, and Clostridium difficile infection.

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 The Association of State Legal Mandates for Data Submission of Central Line–Associated Bloodstream Infections in Neonatal Intensive Care Units with Process and Outcome Measures

2014 ◽  
Vol 35 (9) ◽  
pp. 1133-1139 ◽  
Author(s):  
Philip Zachariah ◽  
Julie Reagan ◽  
E. Yoko Furuya ◽  
Andrew Dick ◽  
Hangsheng Liu ◽  
...  
Keyword(s):  
Intensive Care ◽  
Intensive Care Units ◽  
Outcome Measures ◽  
Neonatal Intensive Care ◽  
Bloodstream Infections ◽  
Central Line ◽  
Neonatal Intensive Care Units ◽  
Data Submission ◽  
Legal Mandates ◽  
Process And Outcome

ObjectiveTo determine the association between state legal mandates for data submission of central line–associated bloodstream infections (CLABSIs) in neonatal intensive care units (NICUs) with process and outcome measures.DesignCross-sectional study.Participants. National sample of level II/III and III NICUs participating in National Healthcare Safety Network (NHSN) surveillance.MethodsState mandates for data submission of CLABSIs in NICUs in place by 2011 were compiled and verified with state healthcare-associated infection coordinators. A web-based survey of infection control departments in October 2011 assessed CLABSI prevention practices, ie, compliance with checklist/bundle components (process measures) in ICUs including NICUs. Corresponding 2011 NHSN NICU CLABSI rates (outcome measures) were used to calculate standardized infection ratios (SIRs). Association between mandates and process and outcome measures was assessed by multivariable logistic regression.ResultsAmong 190 study NICUs, 107 (56.3%) were located in states with mandates, with mandates in place >3 years in 52 (49%). More NICUs in states with mandates reported ≥95% compliance to at least 1 CLABSI prevention practice (52.3%–66.4%) than NICUs in states without mandates (28.9%–48.2%). Mandates were predictors of ≥95% compliance with all practices (odds ratio, 2.8; 95% confidence interval, 1.4–6.1). NICUs in states with mandates reported lower mean CLABSI rates in the ≤750-g birth weight group (2.4 vs 5.7 CLABSIs/1,000 central line–days) but not in others. Mandates were not associated with SIR <1.ConclusionsState mandates for NICU CLABSI data submission were significantly associated with ≥95% compliance with CLABSI prevention practices, which declined with the duration of mandate but not with lower CLABSI rates.Infect Control Hosp Epidemiol 2014;35(9):1133-1139

scholarly journals Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection

2016 ◽  
Vol 18 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Hail M Al-Abdely ◽  
Areej Dhafer Alshehri ◽  
Victor Daniel Rosenthal ◽  
Yassir Khidir Mohammed ◽  
Weam Banjar ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Density ◽  
Multidimensional Approach ◽  
Clabsi Rate

Objective: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. Design: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (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. Results: During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28–0.72; P = 0.001). Conclusions: Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia.

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