Critical care bug team: A multidisciplinary team approach to reducing ventilator-associated pneumonia

Kaye, Judy; Ashline, Vivian; Erickson, Deborah; Zeiler, Kathy; Gavigan, Dawn; Gannon, Lisa; Wynne, Patricia; Cooper, Julian; Kittle, William; Sharma, Kailash Chand; Morton, Jared

doi:10.1016/s0196-6553(00)90028-2

Cited by 18 publications

(1 citation statement)

References 10 publications

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“…Programme implementation included a number of factors shown to be effective in the successful implementation of infection control strategies, such as fostering multidisciplinary collaboration [7], [25]–[27], involving different professional categories [28], encouraging leadership [29], [30], and encouraging the hospital administration to play an active role [30]. Physicians participating in the study team and conducting the simulation training were also part of the clinical team and acted as role models in daily practice [31], [32].…”

Section: Discussionmentioning

confidence: 99%

Hospital-Wide Multidisciplinary, Multimodal Intervention Programme to Reduce Central Venous Catheter-Associated Bloodstream Infection

et al. 2014

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Central line-associated bloodstream infection (CLABSI) is the major complication of central venous catheters (CVC). The aim of the study was to test the effectiveness of a hospital-wide strategy on CLABSI reduction. Between 2008 and 2011, all CVCs were observed individually and hospital-wide at a large university-affiliated, tertiary care hospital. CVC insertion training started from the 3rd quarter and a total of 146 physicians employed or newly entering the hospital were trained in simulator workshops. CVC care started from quarter 7 and a total of 1274 nurses were trained by their supervisors using a web-based, modular, e-learning programme. The study included 3952 patients with 6353 CVCs accumulating 61,366 catheter-days. Hospital-wide, 106 patients had 114 CLABSIs with a cumulative incidence of 1.79 infections per 100 catheters. We observed a significant quarterly reduction of the incidence density (incidence rate ratios [95% confidence interval]: 0.92 [0.88–0.96]; P<0.001) after adjusting for multiple confounders. The incidence densities (n/1000 catheter-days) in the first and last study year were 2.3/1000 and 0.7/1000 hospital-wide, 1.7/1000 and 0.4/1000 in the intensive care units, and 2.7/1000 and 0.9/1000 in non-intensive care settings, respectively. Median time-to-infection was 15 days (Interquartile range, 8-22). Our findings suggest that clinically relevant reduction of hospital-wide CLABSI was reached with a comprehensive, multidisciplinary and multimodal quality improvement programme including aspects of behavioural change and key principles of good implementation practice. This is one of the first multimodal, multidisciplinary, hospital-wide training strategies successfully reducing CLABSI.

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Section: Discussionmentioning

confidence: 99%

Hospital-Wide Multidisciplinary, Multimodal Intervention Programme to Reduce Central Venous Catheter-Associated Bloodstream Infection

et al. 2014

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Semirecumbency Prevents Nosocomial Pneumonia in Mechanically Ventilated Patients

Drakulović

Torres

2002

Anaesthesia, Pain, Intensive Care and Emergency Medicine — A.P.I.C.E.

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Diagnose und Therapie der Sepsis

et al. 2006

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A recent survey conducted by the publicly funded Competence Network Sepsis (Sep- Net) reveals that severe sepsis and/or septic shock occurs in 75,000 inhabitants (110 out of 100,000) and sepsis in 79,000 inhabitants (116 out of 100,000) in Germany annually. This illness is responsible for approx. 60,000 deaths and ranges as the third most frequent cause of death after acute myocardial infarction. Direct costs for the intensive care of patients with severe sepsis alone amount to approx. 1.77 billion euros, which means that about 30% of the budget in intensive care is used to treat severe sepsis. However, until now German guidelines for the diagnosis and therapy of severe sepsis did not exist. Therefore, the German Sepsis Society initiated the development of guidelines which are based on international recommendations by the International Sepsis Forum (ISF) and the Surviving Sepsis Campaign (SSC) and take into account the structure and organisation of the German health care system. Priority was given to the following guideline topics: a) diagnosis, b) prevention, c) causative therapy, d) supportive therapy, e) adjunctive therapy. The guidelines development process was carefully planned and strictly adhered to according to the requirements of the Working Group of Scientific Medical Societies (AWMF).

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Critical care bug team: A multidisciplinary team approach to reducing ventilator-associated pneumonia

Abstract: This study illustrates the effectiveness of a multidisciplinary team approach devised to reduce and stabilize ventilator-associated pneumonia rates in a medical-surgical intensive care unit.

Cited by 18 publications

References 10 publications

Hospital-Wide Multidisciplinary, Multimodal Intervention Programme to Reduce Central Venous Catheter-Associated Bloodstream Infection

Hospital-Wide Multidisciplinary, Multimodal Intervention Programme to Reduce Central Venous Catheter-Associated Bloodstream Infection

Semirecumbency Prevents Nosocomial Pneumonia in Mechanically Ventilated Patients

Diagnose und Therapie der Sepsis

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