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2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey
BACKGROUND: Central-line-associated bloodstream infections comprise 35% of acquired BSI in Israeli intensive care units (ICUs). In 2012, an ongoing national intervention was initiated, including insertion and maintenance bundles, education, outcome surveillance and feedback on CLABSI rates. Followin...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253254/ http://dx.doi.org/10.1093/ofid/ofy210.1744 |
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author | David, Debby Ben Vaturi, Azza Solter, Ester Temkin, Elizabeth Carmeli, Yehuda Schwaber, Mitchell J |
author_facet | David, Debby Ben Vaturi, Azza Solter, Ester Temkin, Elizabeth Carmeli, Yehuda Schwaber, Mitchell J |
author_sort | David, Debby Ben |
collection | PubMed |
description | BACKGROUND: Central-line-associated bloodstream infections comprise 35% of acquired BSI in Israeli intensive care units (ICUs). In 2012, an ongoing national intervention was initiated, including insertion and maintenance bundles, education, outcome surveillance and feedback on CLABSI rates. Following the intervention, a significant decrease in both total BSI and CLABSI rates were observed. However; CLABSI rates remained high in some units. The aims of the study were: (1) to assess the association between hospitals’ implementation of prevention practices and CLABSI incidence in general ICUs and (2) to identify which prevention practices were most important for reducing CLABSI incidence. METHODS: A national, prospective surveillance program was implemented in 2012. Since May 2016, monthly individual data replaced prior aggregated reports. The data includes all positive blood cultures, admission and discharge dates, signs/symptoms and diagnostic procedures dates and presence of central lines. In June 2017, an online survey assessing infection prevention practices in general ICUs was sent to all acute care hospitals. Based on the results of the survey, a 14-element prevention score was created that included presence of unit champions, periodic educational sessions, insertion and maintenance practices, and conducting of routine audits. The association between the prevention score and CLABSI rates during the first 6 months of 2017 was assessed using the Spearman correlation test. Negative binomial regression was used to calculate incident rate ratio. RESULTS: CLABSI rates in 26 general ICUs varied between 0.0 and 17.0 per 1,000 catheter days. Higher prevention scores were associated with lower CLABSI rates (Spearman’s rho = −0.51, P = 0.01; Figure 1). Significant lower rates were observed in ICUs that had wards champions (IRR 0.48 CI 95% 0.32–0.73, P = 0.001) monitored compliance to preventive insertion measures (IRR 0.36, CI 95% 0.20–0.64, P = 0.001), used ultrasound for insertion (IRR 0.48, CI 95% 0.29–0.81, P = 0.006) and used simulations for teaching (IRR 0.41, CI 95% 0.24–0.70; P = 0.001). CONCLUSION: More complete implementation of a multi-faceted intervention was associated with lower CLABSI rates in Israeli ICUs. DISCLOSURES: All authors: No reported disclosures. |
format | Online Article Text |
id | pubmed-6253254 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-62532542018-11-28 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey David, Debby Ben Vaturi, Azza Solter, Ester Temkin, Elizabeth Carmeli, Yehuda Schwaber, Mitchell J Open Forum Infect Dis Abstracts BACKGROUND: Central-line-associated bloodstream infections comprise 35% of acquired BSI in Israeli intensive care units (ICUs). In 2012, an ongoing national intervention was initiated, including insertion and maintenance bundles, education, outcome surveillance and feedback on CLABSI rates. Following the intervention, a significant decrease in both total BSI and CLABSI rates were observed. However; CLABSI rates remained high in some units. The aims of the study were: (1) to assess the association between hospitals’ implementation of prevention practices and CLABSI incidence in general ICUs and (2) to identify which prevention practices were most important for reducing CLABSI incidence. METHODS: A national, prospective surveillance program was implemented in 2012. Since May 2016, monthly individual data replaced prior aggregated reports. The data includes all positive blood cultures, admission and discharge dates, signs/symptoms and diagnostic procedures dates and presence of central lines. In June 2017, an online survey assessing infection prevention practices in general ICUs was sent to all acute care hospitals. Based on the results of the survey, a 14-element prevention score was created that included presence of unit champions, periodic educational sessions, insertion and maintenance practices, and conducting of routine audits. The association between the prevention score and CLABSI rates during the first 6 months of 2017 was assessed using the Spearman correlation test. Negative binomial regression was used to calculate incident rate ratio. RESULTS: CLABSI rates in 26 general ICUs varied between 0.0 and 17.0 per 1,000 catheter days. Higher prevention scores were associated with lower CLABSI rates (Spearman’s rho = −0.51, P = 0.01; Figure 1). Significant lower rates were observed in ICUs that had wards champions (IRR 0.48 CI 95% 0.32–0.73, P = 0.001) monitored compliance to preventive insertion measures (IRR 0.36, CI 95% 0.20–0.64, P = 0.001), used ultrasound for insertion (IRR 0.48, CI 95% 0.29–0.81, P = 0.006) and used simulations for teaching (IRR 0.41, CI 95% 0.24–0.70; P = 0.001). CONCLUSION: More complete implementation of a multi-faceted intervention was associated with lower CLABSI rates in Israeli ICUs. DISCLOSURES: All authors: No reported disclosures. Oxford University Press 2018-11-26 /pmc/articles/PMC6253254/ http://dx.doi.org/10.1093/ofid/ofy210.1744 Text en © The Author(s) 2018. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://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 (http://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 | Abstracts David, Debby Ben Vaturi, Azza Solter, Ester Temkin, Elizabeth Carmeli, Yehuda Schwaber, Mitchell J 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey |
title | 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey |
title_full | 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey |
title_fullStr | 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey |
title_full_unstemmed | 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey |
title_short | 2088. Association Between Implementation of Prevention Practices and CLABSI Incidence: A National Survey |
title_sort | 2088. association between implementation of prevention practices and clabsi incidence: a national survey |
topic | Abstracts |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6253254/ http://dx.doi.org/10.1093/ofid/ofy210.1744 |
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