The Journey to Zero Central Catheter–Associated Bloodstream Infections: Culture Change in an Intensive Care Unit

2012 ◽  
Vol 32 (2) ◽  
pp. 49-54 ◽  
Author(s):  
Sheri L. Southworth ◽  
Lita Jo Henman ◽  
Lisa A. Kinder ◽  
Jennifer L. Sell
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Culture Change ◽  
Bloodstream Infections ◽  
Lessons Learned ◽  
Surgical Intensive Care Unit ◽  
Team Approach ◽  
Surgical Intensive Care ◽  
Life Threatening ◽  
Continuous Feedback

A process change with the goal of decreasing and ultimately eliminating bloodstream infections associated with central catheters in critical care patients was implemented at Riverside Methodist Hospital. This process of implementation resulted in a culture change in the hospital’s medical surgical intensive care unit. Keys to success included a multidisciplinary team approach, support from persons with a stake in the process, and provision of continuous feedback. The lessons learned in this journey at Riverside Methodist Hospital can help caregivers at other hospitals decrease the occurrence of these life-threatening infections.

Arterial catheter-related bloodstream infections: Results of an 8-year survey in a surgical intensive care unit*

2011 ◽  
Vol 39 (6) ◽  
pp. 1372-1376 ◽  
Author(s):  
Romain Pirracchio ◽  
Matthieu Legrand ◽  
Mathieu Resche Rigon ◽  
Joaquim Mateo ◽  
Anne Claire Lukaszewicz ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infections ◽  
Arterial Catheter ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care

Probabilistic Measurement of Central Line–Associated Bloodstream Infections

2015 ◽  
Vol 37 (2) ◽  
pp. 149-155 ◽  
Author(s):  
Bala Hota ◽  
Paul Malpiedi ◽  
Scott K. Fridkin ◽  
John Martin ◽  
William Trick
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Probabilistic Method ◽  
Bloodstream Infections ◽  
Central Line ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Equal Distribution ◽  
Final Model ◽  
C Statistic

OBJECTIVETo develop a probabilistic method for measuring central line–associated bloodstream infection (CLABSI) rates that reduces the variability associated with traditional, manual methods of applying CLABSI surveillance definitions.DESIGNMulticenter retrospective cohort study of bacteremia episodes among patients hospitalized in adult patient-care units; the study evaluated presence of CLABSI.SETTINGHospitals that used SafetySurveillor software system (Premier) and who also reported to the Centers for Disease Control and Prevention’s National Healthcare Safety Network (NHSN).PATIENTSPatients were identified from a stratified sample from all eligible blood culture isolates from all eligible hospital units to generate a final set with an equal distribution (ie, 20%) from each unit type. Units were divided a priori into 5 major groups: medical intensive care unit, surgical intensive care unit, medical-surgical intensive care unit, hematology unit, or general medical wards.INTERVENTIONSEpisodes were reviewed by 2 experts, and a selection of discordant reviews were re-reviewed. Data were joined with NHSN data for hospitals for in-plan months. A predictive model was created; model performance was assessed using the c statistic in a validation set and comparison with NHSN reported rates for in-plan months.RESULTSA final model was created with predictors of CLABSI. The c statistic for the final model was 0.75 (0.68–0.80). Rates from regression modeling correlated better with expert review than NHSN-reported rates.CONCLUSIONSThe use of a regression model based on the clinical characteristics of the bacteremia outperformed traditional infection preventionist surveillance compared with an expert-derived reference standard.Infect. Control Hosp. Epidemiol. 2016;37(2):149–155

Use of a 1-Piece Chlorhexidine Gluconate Transparent Dressing on Critically Ill Patients

2012 ◽  
Vol 32 (4) ◽  
pp. 35-40 ◽  
Author(s):  
Barbara Pfaff ◽  
Teresa Heithaus ◽  
Madeline Emanuelsen
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Cost Savings ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Chlorhexidine Gluconate ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Healthcare Improvement ◽  
Low Rate

Background New transparent dressings with chlorhexidine gluconate in the dressing are available. Objectives To compare the effectiveness of a new 1-piece occlusive dressing that incorporates chlorhexidine gluconate with that of a dressing plus a chlorhexidine gluconate patch in maintaining the low rate of catheter-related bloodstream infections in the intensive care unit and to evaluate nurses’ satisfaction with and cost of the new dressing. Methods A quality improvement observational study was done in an adult medical-surgical intensive care unit. All patients with a central venous catheter had initial and/or subsequent dressing changes done with the new dressing. The central catheter bundle elements of the Institute for Healthcare Improvement were followed. Patients were monitored for catheter-related bloodstream infections, and the rate of infection was calculated. Results During the study period of 1881 device days, the infection rate was 0.051 per 1000 device days, compared with a rate of 0.052 in 2008. Nurses preferred the new dressing. Cost savings were $3807. Conclusion A low rate of catheter-related bloodstream infections can be maintained, nurses’ satisfaction achieved, and cost savings realized with the new dressing.

scholarly journals Risk Factors for Candidal Bloodstream Infections in Surgical Intensive Care Unit Patients: The NEMIS Prospective Multicenter Study

2001 ◽  
Vol 33 (2) ◽  
pp. 177-186 ◽  
Author(s):  
Henry M. Blumberg ◽  
William R. Jarvis ◽  
J. Michael Soucie ◽  
Jack E. Edwards ◽  
Jan E. Patterson ◽  
...  
Keyword(s):  
Risk Factors ◽  
Intensive Care Unit ◽  
Intensive Care ◽  
Multicenter Study ◽  
Bloodstream Infections ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care ◽  
Prospective Multicenter Study

Effect of an education program on decreasing catheter-related bloodstream infections in the surgical intensive care unit

2002 ◽  
Vol 30 (1) ◽  
pp. 59-64 ◽  
Author(s):  
Craig M. Coopersmith ◽  
Terri L. Rebmann ◽  
Jeanne E. Zack ◽  
Myrna R. Ward ◽  
Roslyn M. Corcoran ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Education Program ◽  
Bloodstream Infections ◽  
Surgical Intensive Care Unit ◽  
Surgical Intensive Care
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