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A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model

BACKGROUND: Although there are simple and low-cost measures to prevent healthcare-associated infections (HAIs), they remain a major public health problem. Quality issues and a lack of knowledge about HAI control among healthcare professionals may contribute to this scenario. In this study, our aim i...

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Autores principales: Tuma, Paula, Vieira Junior, Jose M, Ribas, Elenara, Silva, Karen C C D, Gushken, Andrea K F, Torelly, Ethel M S, de Moura, Rafaela M, Tavares, Bruno M, Prandini, Cristiana M, Borem, Paulo, Delgado, Pedro, Ue, Luciana Y, de Barros, Claudia G, Vernal, Sebastian
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109530/
https://www.ncbi.nlm.nih.gov/pubmed/37077504
http://dx.doi.org/10.1093/ofid/ofad129
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author Tuma, Paula
Vieira Junior, Jose M
Ribas, Elenara
Silva, Karen C C D
Gushken, Andrea K F
Torelly, Ethel M S
de Moura, Rafaela M
Tavares, Bruno M
Prandini, Cristiana M
Borem, Paulo
Delgado, Pedro
Ue, Luciana Y
de Barros, Claudia G
Vernal, Sebastian
author_facet Tuma, Paula
Vieira Junior, Jose M
Ribas, Elenara
Silva, Karen C C D
Gushken, Andrea K F
Torelly, Ethel M S
de Moura, Rafaela M
Tavares, Bruno M
Prandini, Cristiana M
Borem, Paulo
Delgado, Pedro
Ue, Luciana Y
de Barros, Claudia G
Vernal, Sebastian
author_sort Tuma, Paula
collection PubMed
description BACKGROUND: Although there are simple and low-cost measures to prevent healthcare-associated infections (HAIs), they remain a major public health problem. Quality issues and a lack of knowledge about HAI control among healthcare professionals may contribute to this scenario. In this study, our aim is to present the implementation of a project to prevent HAIs in intensive care units (ICUs) using the quality improvement (QI) collaborative model Breakthrough Series (BTS). METHODS: A QI report was conducted to assess the results of a national project in Brazil between January 2018 and February 2020. A 1-year preintervention analysis was conducted to determine the incidence density baseline of the 3 main HAIs: central line-associated bloodstream infections (CLABSIs), ventilation-associated pneumonia (VAP), and catheter-associated urinary tract infections (CA-UTIs). The BTS methodology was applied during the intervention period to coach and empower healthcare professionals providing evidence-based, structured, systematic, and auditable methodologies and QI tools to improve patients’ care outcomes. RESULTS: A total of 116 ICUs were included in this study. The 3 HAIs showed a significant decrease of 43.5%, 52.1%, and 65.8% for CLABSI, VAP, and CA-UTI, respectively. A total of 5140 infections were prevented. Adherence to bundles inversely correlated with the HAI incidence densities: CLABSI insertion and maintenance bundle (R = −0.50, P = .010 and R = −0.85, P < .001, respectively), VAP prevention bundle (R = −0.69, P < .001), and CA-UTI insertion and maintenance bundle (R = −0.82, P < .001 and R = −0.54, P = .004, respectively). CONCLUSIONS: Descriptive data from the evaluation of this project show that the BTS methodology is a feasible and promising approach to preventing HAIs in critical care settings.
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spelling pubmed-101095302023-04-18 A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model Tuma, Paula Vieira Junior, Jose M Ribas, Elenara Silva, Karen C C D Gushken, Andrea K F Torelly, Ethel M S de Moura, Rafaela M Tavares, Bruno M Prandini, Cristiana M Borem, Paulo Delgado, Pedro Ue, Luciana Y de Barros, Claudia G Vernal, Sebastian Open Forum Infect Dis Major Article BACKGROUND: Although there are simple and low-cost measures to prevent healthcare-associated infections (HAIs), they remain a major public health problem. Quality issues and a lack of knowledge about HAI control among healthcare professionals may contribute to this scenario. In this study, our aim is to present the implementation of a project to prevent HAIs in intensive care units (ICUs) using the quality improvement (QI) collaborative model Breakthrough Series (BTS). METHODS: A QI report was conducted to assess the results of a national project in Brazil between January 2018 and February 2020. A 1-year preintervention analysis was conducted to determine the incidence density baseline of the 3 main HAIs: central line-associated bloodstream infections (CLABSIs), ventilation-associated pneumonia (VAP), and catheter-associated urinary tract infections (CA-UTIs). The BTS methodology was applied during the intervention period to coach and empower healthcare professionals providing evidence-based, structured, systematic, and auditable methodologies and QI tools to improve patients’ care outcomes. RESULTS: A total of 116 ICUs were included in this study. The 3 HAIs showed a significant decrease of 43.5%, 52.1%, and 65.8% for CLABSI, VAP, and CA-UTI, respectively. A total of 5140 infections were prevented. Adherence to bundles inversely correlated with the HAI incidence densities: CLABSI insertion and maintenance bundle (R = −0.50, P = .010 and R = −0.85, P < .001, respectively), VAP prevention bundle (R = −0.69, P < .001), and CA-UTI insertion and maintenance bundle (R = −0.82, P < .001 and R = −0.54, P = .004, respectively). CONCLUSIONS: Descriptive data from the evaluation of this project show that the BTS methodology is a feasible and promising approach to preventing HAIs in critical care settings. Oxford University Press 2023-03-09 /pmc/articles/PMC10109530/ /pubmed/37077504 http://dx.doi.org/10.1093/ofid/ofad129 Text en © The Author(s) 2023. Published by Oxford University Press on behalf of Infectious Diseases Society of America. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Major Article
Tuma, Paula
Vieira Junior, Jose M
Ribas, Elenara
Silva, Karen C C D
Gushken, Andrea K F
Torelly, Ethel M S
de Moura, Rafaela M
Tavares, Bruno M
Prandini, Cristiana M
Borem, Paulo
Delgado, Pedro
Ue, Luciana Y
de Barros, Claudia G
Vernal, Sebastian
A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model
title A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model
title_full A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model
title_fullStr A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model
title_full_unstemmed A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model
title_short A National Implementation Project to Prevent Healthcare-Associated Infections in Intensive Care Units: A Collaborative Initiative Using the Breakthrough Series Model
title_sort national implementation project to prevent healthcare-associated infections in intensive care units: a collaborative initiative using the breakthrough series model
topic Major Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10109530/
https://www.ncbi.nlm.nih.gov/pubmed/37077504
http://dx.doi.org/10.1093/ofid/ofad129
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