Quantitative Results of a National Intervention to Prevent Central Line–Associated Bloodstream Infection

Patel, Payal; Greene, M. Todd; Jones, Karen; Rolle, Andrew J.; Ratz, David; Snyder, Ashley; Saint, Sanjay; Chopra, Vineet

doi:10.7326/m18-3533

Cited by 8 publications

(7 citation statements)

References 27 publications

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“…2,15 Following multicomponent interventions that stressed reducing device utilization and improving maintenance care, impressive initial declines in CLABSIs and CAUTIs can be achieved. [5][6][7][8][9][10]16 However, it appears with time the reductions reach a plateau, 5,13,14 and additional measures may be needed.…”

Section: Discussionmentioning

confidence: 99%

Trends in central-line-associated bloodstream infections and catheter-associated urinary tract infections in a large acute-care hospital system in New York City, 2016-2019

Kaminski

Episcopia

Malik

et al. 2020

Infect. Control Hosp. Epidemiol.

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Background: Central-line bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) negatively impact clinical outcomes and hospital reimbursement. In this report, 4 year trends involving 11 hospitals in New York City were examined. Methods: Data from the National Healthcare Safety Network (NHSN) were extracted for 11 acute-care hospitals belonging to the NYC Health + Hospital system from 2016 through 2019. Trends in device infections per 1,000 patient days, device utilization ratios, and standardized infection ratios (SIRs) were examined for the 11 hospitals and for the entire system. Results: Over the 4-year period, there were progressive declines in central-line days, infections per 1,000 central-line days, and device utilization ratios for the system. The average annual SIRs for the system also declined: 1.40 in 2016, 1.09 in 2017, 1.04 in 2018, and 0.82 in 2019. Case-mix indices correlated with SIRs for CLABSIs. Level 1 trauma centers had higher SIRs and a disproportionately greater number of CLABSIs in patients located in NHSN-defined surgical intensive care units. Similar trends with CAUTIs were noted, with progressive declines in catheter days, infections per 1,000 patient days, device utilization ratios, and SIRs (1.42 in 2016, 0.93 in 2017, 1.18 in 2018, and 0.78 in 2019) over the 4-year period. Conclusions: Across an 11-hospital system, continuing efforts to reduce device utilization and infection rates resulted in declining SIRs for CLABSIs and CAUTIs. Hospitals with higher case-mix indices, and particularly level 1 trauma centers, had significantly higher central-line infection rates and SIRs.

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Section: Discussionmentioning

confidence: 99%

Trends in central-line-associated bloodstream infections and catheter-associated urinary tract infections in a large acute-care hospital system in New York City, 2016-2019

Kaminski

Episcopia

Malik

et al. 2020

Infect. Control Hosp. Epidemiol.

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“…Most were conducted in USA (n=25). [12][13][14]17,19,20,[22][23][24][25][26][27][29][30][31][34][35][36][37]39,40,42,[44][45][46] The remaining studies derived from England (n=2), 11,33 Taiwan (n=2), 16,21 Australia (n=1), 28 Brazil (n=1), 15 Germany (n=1), 18 Israel (n=1), 38 Italy (n=1), 43 New Zealand (n=1), 32 and Republic of Ireland (n=1). 41 Study designs included 21 ITS, 12,14,[17][18][19][20][21]24,[29][30][31][32][33][34]…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…41 Study designs included 21 ITS, 12,14,[17][18][19][20][21]24,[29][30][31][32][33][34][37][38][39][40][41]43,44 nine CBAs, 13,16,22,23,25,28,35,45,46 four cluster-randomised trials (CRTs), 15,26,27,42 and two NRTs. 11,36 Interventions were categorised according to the type of intervention, including care bundles, 16,39 care bundles with implementation strategies, [11][12][13]18,21,26,31,43,46 IPC programmes 14,15,17,…”

Section: Overview Of Included Studiesmentioning

confidence: 99%

“…In 16 studies the interventions were various IPC programmes, including quality improvement projects, 14,15,17,20,29,30,32,[34][35][36]40,42 hand hygiene programmes, 28,41 appointment of infection control task force, 38 and an intervention consisting of five campaigns involving hand hygiene promotion, a clean hospital environment, care for catheter devices, MRSA screening and ventilated patient care recommendations. 33 Six ITS 14,29,33,34,40,41 and two CRTs 15,42 investigated the effect of an IPC programmes on BSI rates amongst ICU, 15,29,40,42 or acute hospital patients. 14,33,34,41 Two of these studies 14,34 investigated the effect of the "States Targeting Reduction in Infections via Engagement" (STRIVE) programme on CLABSIs rates in general, 34 or hospital-onset MRSA BSIs.…”

Section: Infection Prevention and Control Programmesmentioning

confidence: 99%

“…33 Six ITS 14,29,33,34,40,41 and two CRTs 15,42 investigated the effect of an IPC programmes on BSI rates amongst ICU, 15,29,40,42 or acute hospital patients. 14,33,34,41 Two of these studies 14,34 investigated the effect of the "States Targeting Reduction in Infections via Engagement" (STRIVE) programme on CLABSIs rates in general, 34 or hospital-onset MRSA BSIs. 14 The remaining studies investigated the effect of various IPC quality improvement programmes on reducing the rates of CLABSIs, 15,29,40,42 or national IPC campaigns on BSI caused by specific microorganism, i.e.…”

Section: Infection Prevention and Control Programmesmentioning

confidence: 99%

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This document introduces and explains common implementation concepts and frameworks relevant to healthcare epidemiology and infection prevention and control and can serve as a stand-alone guide or be paired with the “SHEA/IDSA/APIC Compendium of Strategies to Prevent Healthcare-Associated Infections in Acute Care Hospitals: 2022 Updates,” which contain technical implementation guidance for specific healthcare-associated infections. This Compendium article focuses on broad behavioral and socio-adaptive concepts and suggests ways that infection prevention and control teams, healthcare epidemiologists, infection preventionists, and specialty groups may utilize them to deliver high-quality care. Implementation concepts, frameworks, and models can help bridge the “knowing-doing” gap, a term used to describe why practices in healthcare may diverge from those recommended according to evidence. It aims to guide the reader to think about implementation and to find resources suited for a specific setting and circumstances by describing strategies for implementation, including determinants and measurement, as well as the conceptual models and frameworks: 4Es, Behavior Change Wheel, CUSP, European and Mixed Methods, Getting to Outcomes, Model for Improvement, RE-AIM, REP, and Theoretical Domains.

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Quantitative Results of a National Intervention to Prevent Central Line–Associated Bloodstream Infection

Cited by 8 publications

References 27 publications

Trends in central-line-associated bloodstream infections and catheter-associated urinary tract infections in a large acute-care hospital system in New York City, 2016-2019

Trends in central-line-associated bloodstream infections and catheter-associated urinary tract infections in a large acute-care hospital system in New York City, 2016-2019

Effectiveness of national and subnational interventions for prevention and control of health-care-associated infections in acute hospitals in high-income and upper-middle-income counties: a systematic review update

Implementing strategies to prevent infections in acute-care settings

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