دورية أكاديمية
Implementation of tailored interventions in a statewide programme to reduce central line-associated bloodstream infections.
| العنوان: | Implementation of tailored interventions in a statewide programme to reduce central line-associated bloodstream infections. |
|---|---|
| المؤلفون: | Assis DB; Division of Nosocomial Infections, Center for Epidemiologic Surveillance 'Prof. Alexandre Vranjac', Center of Disease Control, São Paulo State Health Department, São Paulo, Brazil. Electronic address: dbassis@gmail.com., Madalosso G; Division of Nosocomial Infections, Center for Epidemiologic Surveillance 'Prof. Alexandre Vranjac', Center of Disease Control, São Paulo State Health Department, São Paulo, Brazil., Padoveze MC; Department of Collective Health Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil., Lobo RD; Department of Infection Control, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Oliveira MS; Department of Infection Control, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Boszczowski Í; Department of Infection Control, Hospital das Clínicas, University of São Paulo, São Paulo, Brazil., Singer JM; Department of Statistics, University of São Paulo, São Paulo, Brazil., Levin AS; Department of Collective Health Nursing, School of Nursing, University of São Paulo, São Paulo, Brazil; Department of Infectious Diseases and LIM54, University of São Paulo, São Paulo, Brazil; Institute of Tropical Medicine, University of São Paulo, São Paulo, Brazil. |
| المصدر: | The Journal of hospital infection [J Hosp Infect] 2018 Nov; Vol. 100 (3), pp. e163-e168. Date of Electronic Publication: 2018 May 04. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: W.B. Saunders For The Hospital Infection Society Country of Publication: England NLM ID: 8007166 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1532-2939 (Electronic) Linking ISSN: 01956701 NLM ISO Abbreviation: J Hosp Infect Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: London : W.B. Saunders For The Hospital Infection Society Original Publication: New York, Academic Press. |
| مواضيع طبية MeSH: | Attitude of Health Personnel*, Catheter-Related Infections/*prevention & control , Catheterization, Central Venous/*adverse effects , Infection Control/*methods , Sepsis/*prevention & control, Brazil/epidemiology ; Catheter-Related Infections/epidemiology ; Developing Countries ; Guideline Adherence ; Humans ; Intensive Care Units ; Non-Randomized Controlled Trials as Topic ; Prospective Studies ; Risk-Taking ; Sepsis/epidemiology ; Surveys and Questionnaires |
| مستخلص: | Background: There have been few studies exploring implementation strategies to central line-associated bloodstream infections (CLABSIs) in low- or middle-income countries. Aim: To implement tailored interventions to reduce CLABSI rates in adult intensive care units. Methods: The implementation strategy of the State Health Department was performed in São Paulo State, Brazil, over two cycles. Cycle 1 (56 hospitals) was exploratory and cycle 2 (77 hospitals) was designed to confirm the hypothesis generated by the first cycle, with three phases each (pre-intervention, intervention, post-intervention). Cycles included: evaluation of healthcare workers' knowledge, observation of practices, and CLABSI rates monthly report. In cycle 1, a log-normal mixed model was used to select variables significantly associated with the reduction of CLABSI. In cycle 2, CLABSI rates were evaluated. Findings: Healthcare workers' practices improved after intervention. In cycle 1, reduction of CLABSI rates was more pronounced in hospitals with initial CLABSI rates >7.4 per 1000 catheter-days (P < 0.001) and those that introduced the use of peripherally inserted central catheters (P = 0.01). For hospitals with high CLABSI initial rates, simulation demonstrated that the rates were expected to decrease by 36% (95% CI: 9-63), no matter the type of intervention. In cycle 2, there was an overall decrease in CLABSI rates during the intervention period; whereas the mean rate fell further post-intervention, rates at the 90 th percentile increased. Conclusion: The implementation strategy may have had an effect on infection rates independently of the specific interventions implemented; however, the sustainability of reduction in the post-intervention period remains a challenge. (Copyright © 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Central line-associated bloodstream infection; Interventions; Surveillance |
| تواريخ الأحداث: | Date Created: 20180507 Date Completed: 20181217 Latest Revision: 20181217 |
| رمز التحديث: | 20231215 |
| DOI: | 10.1016/j.jhin.2018.04.020 |
| PMID: | 29730142 |
| قاعدة البيانات: | MEDLINE |
Full Text via ClinicalKey 
Full Text Finder كن أول من يترك تعليقا!