A multicenter intervention to prevent catheter-associated bloodstream infections Journal Article

  


Authors: Warren, D. K.; Cosgrove, S. E.; Diekema, D. J.; Zuccotti, G.; Climo, M. W.; Bolon, M. K.; Tokars, J. I.; Noskin, G. A.; Wong, E. S.; Sepkowitz, K. A.; Herwaldt, L. A.; Perl, T. M.; Solomon, S. L.; Fraser, V. J.
Article Title: A multicenter intervention to prevent catheter-associated bloodstream infections
Abstract: BACKGROUND. Education-based interventions can reduce the incidence of catheter-associated bloodstream infection. The generalizability of findings from single-center studies is limited. OBJECTIVE. To assess the effect of a multicenter intervention to prevent catheter-associated bloodstream infections. DESIGN. An observational study with a planned intervention. SETTING. Twelve intensive care units and 1 bone marrow transplantation unit at 6 academic medical centers. PATIENTS. Patients admitted during the study period. INTERVENTION. Updates of written policies, distribution of a 9-page self-study module with accompanying pretest and posttest, didactic lectures, and incorporation into practice of evidence-based guidelines regarding central venous catheter (CVC) insertion and care. MEASUREMENTS. Standard data collection tools and definitions were used to measure the process of care (ie, the proportion of nontunneled catheters inserted into the femoral vein and the condition of the CVC insertion site dressing for both tunneled and nontunneled catheters) and the incidence of catheter-associated bloodstream infection. RESULTS. Between the preintervention period and the postintervention period, the percentage of CVCs inserted into the femoral vein decreased from 12.9% to 9.4% (relative ratio, 0.73; 95% confidence interval [CI], 0.61-0.88); the total proportion of catheter insertion site dressings properly dated increased from 26.6% to 34.4% (relative ratio, 1.29; 95% CI, 1.17-1.42), and the overall rate of catheter-associated bloodstream infections decreased from 11.2 to 8.9 infections per 1,000 catheter-days (relative rate, 0.79; 95% CI, 0.67-0.93). The effect of the intervention varied among individual units. CONCLUSIONS. An education-based intervention that uses evidence-based practices can be successfully implemented in a diverse group of medical and surgical units and reduce catheter-associated bloodstream infection rates. © 2006 by The Society for Healthcare Epidemiology of America. All rights reserved.
Keywords: controlled study; major clinical study; clinical trial; demography; controlled clinical trial; clinical assessment; incidence; evidence based practice; practice guideline; health care policy; patient care; intensive care unit; intensive care units; multicenter study; sepsis; hospital admission; bacteremia; bone marrow transplantation; catheter infection; catheters, indwelling; central venous catheter; academic medical centers; health center; femoral vein
Journal Title: Infection Control and Hospital Epidemiology
Volume: 27
Issue: 7
ISSN: 0899-823X
Publisher: The Society for Healthcare Epidemiology of America  
Date Published: 2006-07-01
Start Page: 662
End Page: 669
Language: English
DOI: 10.1086/506184
PUBMED: 16807839
PROVIDER: scopus
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-33747721375&partnerID=40&md5=11b3f59f5620b53539a0fa180c2f0a95
Notes: --- - "Cited By (since 1996): 49" - "Export Date: 4 June 2012" - "CODEN: ICEPE" - "Source: Scopus"
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MSK Authors
  1. Kent A Sepkowitz
    273 Sepkowitz
  2. Gianna Zuccotti
    13 Zuccotti
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