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Quantitative Results of a National Intervention to Prevent Central Line-Associated Bloodstream Infection: A Pre-Post Observational Study.

Abstract：

Background:Central line-associated bloodstream infection (CLABSI) remains prevalent in hospitals in the United States. Objective:To evaluate the impact of a multimodal intervention in hospitals with elevated rates of health care-associated infection. Design:Pre-post observational evaluation of a prospective, national, clustered, nonrandomized initiative of 3 cohorts of hospitals. Setting:Acute care, long-term acute care, and critical access hospitals, including intensive care units and medical/surgical wards. Participants:Target hospitals had a cumulative attributable difference above the first tertile of performance for Clostridioides difficile infection and another health care-associated infection (such as CLABSI). Some hospitals that did not meet these criteria also participated. Intervention:A multimodal intervention consisting of recommendations and tools for prioritizing and implementing evidence-based infection prevention strategies, on-demand educational videos, webinars led by content experts, and access to content experts. Measurements:Rates of CLABSI and device utilization ratio pre- and postintervention. Results:Between November 2016 and May 2018, 387 hospitals in 23 states and the District of Columbia participated. Monthly preimplementation CLABSI rates ranged from 0 to 71.4 CLABSIs per 1000 catheter-days. Over the study period, the unadjusted CLABSI rate was low and decreased from 0.88 to 0.80 CLABSI per 1000 catheter-days. Between the pre- and postintervention periods, device utilization decreased from 24.05 to 22.07 central line-days per 100 patient-days. However, a decreasing trend in device utilization was also observed during the preintervention period. Limitations:The intervention period was brief. Participation in and adherence to recommended interventions were not fully assessed. Rates of CLABSI were low. Patient characteristics could not be assessed. Conclusion:In hospitals with a disproportionate burden of health care-associated infection, a multimodal intervention did not reduce rates of CLABSI. Primary Funding Source:Centers for Disease Control and Prevention.

journal_name

Ann Intern Med

journal_title

Annals of internal medicine

authors

Patel PK,Greene MT,Jones K,Rolle AJ,Ratz D,Snyder A,Saint S,Chopra V

doi

10.7326/M18-3533

subject

Has Abstract

pub_date

2019-10-01 00:00:00

pages

S23-S29

issue

7_Suppl

eissn

0003-4819

issn

1539-3704

pii

2752409

journal_volume

171

pub_type

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Quantitative Results of a National Intervention to Prevent Central Line-Associated Bloodstream Infection: A Pre-Post Observational Study.