Using the agile implementation model to reduce central line-associated bloodstream infections.


Journal

American journal of infection control
ISSN: 1527-3296
Titre abrégé: Am J Infect Control
Pays: United States
ID NLM: 8004854

Informations de publication

Date de publication:
01 2019
Historique:
received: 22 05 2018
revised: 06 07 2018
accepted: 08 07 2018
pubmed: 12 9 2018
medline: 21 1 2020
entrez: 12 9 2018
Statut: ppublish

Résumé

Central line-associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI. We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017. The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable. Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.

Sections du résumé

BACKGROUND
Central line-associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI.
METHODS
We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017.
RESULTS
The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable.
CONCLUSIONS
Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.

Identifiants

pubmed: 30201414
pii: S0196-6553(18)30751-X
doi: 10.1016/j.ajic.2018.07.008
pii:
doi:

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

33-37

Informations de copyright

Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

Auteurs

Jose Azar (J)

Indiana Clinical Translational Sciences Institute, Indiana University, Indianapolis, IN; Center for Health Innovation and Implementation Science, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health, Indianapolis, IN.

Kristen Kelley (K)

Indiana University Health, Indianapolis, IN.

Jennifer Dunscomb (J)

Indiana University Health, Indianapolis, IN.

Anthony Perkins (A)

Indiana University School of Medicine, Indianapolis, IN.

Yun Wang (Y)

Indiana University Health, Indianapolis, IN.

Cole Beeler (C)

Indiana University Health, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.

Lana Dbeibo (L)

Indiana University Health, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.

Douglas Webb (D)

Indiana University Health, Indianapolis, IN.

Larry Stevens (L)

Indiana University School of Medicine, Indianapolis, IN.

Mark Luektemeyer (M)

Indiana University Health, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.

Areeba Kara (A)

Indiana University Health, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.

Ryan Nagy (R)

Indiana University Health, Indianapolis, IN; Indiana University School of Medicine, Indianapolis, IN.

Craig A Solid (CA)

Solid Research Group LLC, St. Paul, MN. Electronic address: csolid@solidresearchgroup.com.

Malaz Boustani (M)

Indiana Clinical Translational Sciences Institute, Indiana University, Indianapolis, IN; Center for Health Innovation and Implementation Science, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health, Indianapolis, IN; Regenstrief Institute, Inc., Indianapolis, IN.

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