Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era

Marra, Alexandre R.; Cal, Ruy Guilherme Rodrigues; Durão, Marcelino S.; Corrêa, Luci; Guastelli, Luciana Reis; Moura, Denis Faria; Edmond, Michael B.; Santos, Oscar Fernando Pavão dos

doi:10.1016/j.ajic.2009.11.012

Cited by 77 publications

(48 citation statements)

References 15 publications

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“…Eight of them (53,3%) were developed in the USA (6,9,(15)(16)18,(22)(23)25) and only three (20%) were developed in Latin America, two of them in Brazil (20)(21) and one in Colombia (14) .…”

Section: Resultsmentioning

confidence: 99%

“…The use of Peripherally Inserted Central Catheter (PICC) was mentioned in four studies (14)(15)(21)(22) and only one of them describes infection rates per catheter type (14) .…”

Section: Resultsmentioning

confidence: 99%

“…Articles analysis regarding the type of bundle methodology described showed that they were composed of at least three and at most six interventions and the majority of the prospective studies presented statistically significant results regarding CRBSI and CLABSI reduction, being CLABSI the object of study in most of the articles (9,(15)(16)(19)(20)(21)(22)25) . Table 1 presents the summary of the interventions described as bundle elements and the number of times that each strategy was listed in the fifteen analyzed articles.…”

Section: Resultsmentioning

confidence: 99%

“…Bundle can include constant surveillance, health staff education, training of catheterinserting / handling staff and prevention strategies against bloodstream infection (9,14,(16)(17)(18)(19)(20)(21)(22)(23)(24) .…”

Section: Defining Bundlementioning

confidence: 99%

“…The use o maximal barrier precautions for CVC insertion is an IB recommendation (28) and it was described in thirteen articles (5)(6)(14)(15)(16)(17)(18)(19)(21)(22)(23)(24)(25) .…”

Section: Bundle and Cvc Insertion Carementioning

confidence: 99%

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Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa

Brachine¹,

Peterlini

Pedreira

2012

Rev. Gaúcha Enferm.

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Trata-se de uma revisão integrativa da literatura, que objetivou identificar intervenções baseadas em evidência que compõem o método bundle, designados à redução de infecção de corrente sanguínea relacionada ou associada a cateter intravenoso central. Para a coleta de dados online, em bases nacionais e internacionais, foram utilizados a palavra-chave bundle e os descritores catheter-related infection, infection control e central venous catheterization, resultando, após aplicação dos critérios de inclusão, amostra de quinze artigos. Este trabalho evidenciou cinco intervenções como as mais frequentemente empregadas na construção dos bundles: higienização das mãos, gluconato de clorexidina como antisséptico para pele, uso de barreira máxima de precaução durante a inserção cateter, evitar acessar veia femoral e verificar necessidade diária de permanência do cateter, com sua remoção imediata quando não mais indicado. A maioria dos estudos demonstrou resultados estatisticamente significantes na redução de infecção de corrente sanguínea relacionada ou associada a cateter intravenoso central.

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“…Eight of them (53,3%) were developed in the USA (6,9,(15)(16)18,(22)(23)25) and only three (20%) were developed in Latin America, two of them in Brazil (20)(21) and one in Colombia (14) .…”

Section: Resultsmentioning

confidence: 99%

“…The use of Peripherally Inserted Central Catheter (PICC) was mentioned in four studies (14)(15)(21)(22) and only one of them describes infection rates per catheter type (14) .…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Defining Bundlementioning

confidence: 99%

“…The use o maximal barrier precautions for CVC insertion is an IB recommendation (28) and it was described in thirteen articles (5)(6)(14)(15)(16)(17)(18)(19)(21)(22)(23)(24)(25) .…”

Section: Bundle and Cvc Insertion Carementioning

confidence: 99%

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Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa

Brachine¹,

Peterlini

Pedreira

2012

Rev. Gaúcha Enferm.

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Rapid reduction of central line infections in hospitalized pediatric oncology patients through simple quality improvement methods

Choi

Chang

Hanauer

et al. 2012

Pediatric Blood & Cancer

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Background Pediatric hematology-oncology (PHO) patients are at significant risk for developing central line-associated bloodstream infections (CLA-BSIs) due to their prolonged dependence on such catheters. Effective strategies to eliminate these preventable infections are urgently needed. In this study, we investigated the implementation of bundled central line maintenance practices and their effect on hospital-acquired CLA-BSIs. Materials and Methods CLA-BSI rates were analyzed within a single-institution’s PHO unit between January 2005 and June 2011. In May 2008, a multidisciplinary quality improvement team developed techniques to improve the PHO unit’s safety culture and implemented the use of catheter maintenance practices tailored to PHO patients. Data analysis was performed using time-series methods to evaluate the pre- and post-intervention effect of the practice changes. Results The pre-intervention CLA-BSI incidence was 2.92 per 1000-patient days (PD) and coagulase-negative Staphylococcus was the most prevalent pathogen (29%). In the post-intervention period, the CLA-BSI rate decreased substantially (45%) to 1.61 per 1000-PD (p<0.004). Early on, blood and marrow transplant (BMT) patients had a three-fold higher CLA-BSI rate compared to non-BMT patients (p<0.033). With additional infection control countermeasures added to the bundled practices, BMT patients experienced a larger CLA-BSI rate reduction such that BMT and non-BMT CLA-BSI rates were not significantly different post-intervention. Conclusions By adopting and effectively implementing uniform maintenance catheter care practices, learning multidisciplinary teamwork, and promoting a culture of patient safety, the CLA-BSI incidence in our study population was significantly reduced and maintained.

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Endovascular Infections and Endocarditis

Zingg

Pittet

2019

Principles and Practice of Transplant Infectious Diseases

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Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era

Cited by 77 publications

References 15 publications

Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa

Método bundle na redução de infecção de corrente sanguínea relacionada a cateteres centrais: revisão integrativa

Rapid reduction of central line infections in hospitalized pediatric oncology patients through simple quality improvement methods

Endovascular Infections and Endocarditis

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