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Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections
BACKGROUND: Central line-associated bloodstream infections (CLABSI) represent a serious patient safety issue. To prevent these infections, bundled interventions are increasingly recommended. We examine the extent of adoption of Central Line (CL) Bundle elements throughout US intensive care units (IC...
Autores principales: | , , , , , |
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Formato: | Texto |
Lenguaje: | English |
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Public Library of Science
2011
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022589/ https://www.ncbi.nlm.nih.gov/pubmed/21267440 http://dx.doi.org/10.1371/journal.pone.0015452 |
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author | Furuya, E. Yoko Dick, Andrew Perencevich, Eli N. Pogorzelska, Monika Goldmann, Donald Stone, Patricia W. |
author_facet | Furuya, E. Yoko Dick, Andrew Perencevich, Eli N. Pogorzelska, Monika Goldmann, Donald Stone, Patricia W. |
author_sort | Furuya, E. Yoko |
collection | PubMed |
description | BACKGROUND: Central line-associated bloodstream infections (CLABSI) represent a serious patient safety issue. To prevent these infections, bundled interventions are increasingly recommended. We examine the extent of adoption of Central Line (CL) Bundle elements throughout US intensive care units (ICU) and determine their effectiveness in preventing CLABSIs. METHODOLOGY/PRINCIPAL FINDINGS: In this cross-sectional study, National Healthcare Safety Network (NHSN) hospitals provided the following: ICU-specific NHSN-reported rates of CLABSI/1,000 central line days; policies and compliance rates regarding bundle components; and other setting characteristics. In 250 hospitals the mean CLABSI rate was 2.1 per 1000 central line days and 49% reported having a written CL Bundle policy. However, of those that monitored compliance, only 38% reported very high compliance with the CL Bundle. Only when an ICU had a policy, monitored compliance, and had ≥95% compliance did CLABSI rates decrease. Complying with any one of three CL Bundle elements resulted in decreased CLABSI rates (β = -1.029, p = 0.015). If an ICU without good bundle compliance achieved high compliance with any one bundle element, we estimated that its CLABSI rate would decrease by 38%. CONCLUSIONS/SIGNIFICANCE: In NHSN hospitals across the US, the CL Bundle is associated with lower infection rates only when compliance is high. Hospitals must target improving bundle implementation and compliance as opposed to simply instituting policies. |
format | Text |
id | pubmed-3022589 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2011 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-30225892011-01-25 Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections Furuya, E. Yoko Dick, Andrew Perencevich, Eli N. Pogorzelska, Monika Goldmann, Donald Stone, Patricia W. PLoS One Research Article BACKGROUND: Central line-associated bloodstream infections (CLABSI) represent a serious patient safety issue. To prevent these infections, bundled interventions are increasingly recommended. We examine the extent of adoption of Central Line (CL) Bundle elements throughout US intensive care units (ICU) and determine their effectiveness in preventing CLABSIs. METHODOLOGY/PRINCIPAL FINDINGS: In this cross-sectional study, National Healthcare Safety Network (NHSN) hospitals provided the following: ICU-specific NHSN-reported rates of CLABSI/1,000 central line days; policies and compliance rates regarding bundle components; and other setting characteristics. In 250 hospitals the mean CLABSI rate was 2.1 per 1000 central line days and 49% reported having a written CL Bundle policy. However, of those that monitored compliance, only 38% reported very high compliance with the CL Bundle. Only when an ICU had a policy, monitored compliance, and had ≥95% compliance did CLABSI rates decrease. Complying with any one of three CL Bundle elements resulted in decreased CLABSI rates (β = -1.029, p = 0.015). If an ICU without good bundle compliance achieved high compliance with any one bundle element, we estimated that its CLABSI rate would decrease by 38%. CONCLUSIONS/SIGNIFICANCE: In NHSN hospitals across the US, the CL Bundle is associated with lower infection rates only when compliance is high. Hospitals must target improving bundle implementation and compliance as opposed to simply instituting policies. Public Library of Science 2011-01-18 /pmc/articles/PMC3022589/ /pubmed/21267440 http://dx.doi.org/10.1371/journal.pone.0015452 Text en Furuya et al. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Furuya, E. Yoko Dick, Andrew Perencevich, Eli N. Pogorzelska, Monika Goldmann, Donald Stone, Patricia W. Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections |
title | Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections |
title_full | Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections |
title_fullStr | Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections |
title_full_unstemmed | Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections |
title_short | Central Line Bundle Implementation in US Intensive Care Units and Impact on Bloodstream Infections |
title_sort | central line bundle implementation in us intensive care units and impact on bloodstream infections |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3022589/ https://www.ncbi.nlm.nih.gov/pubmed/21267440 http://dx.doi.org/10.1371/journal.pone.0015452 |
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