Impact of self-reported guideline compliance: Bloodstream infection prevention in a national collaborative
Background We sought to examine self-reported compliance with 5 evidence-based central line–associated bloodstream infection (CLABSI) prevention practices and link compliance to CLABSI rates in a national patient safety collaborative. Methods We analyzed data from a national CLABSI prevention progra...
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| Veröffentlicht in: | American journal of infection control 2014-10, Vol.42 (10), p.S191-S196 |
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| container_title | American journal of infection control |
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| creator | Hsu, Yea-Jen, PhD, MHA Weeks, Kristina, DrPH(c), MHS Yang, Ting, PhD Sawyer, Melinda D., MSN, RN, CNS-BC Marsteller, Jill A., PhD, MPP |
| description | Background We sought to examine self-reported compliance with 5 evidence-based central line–associated bloodstream infection (CLABSI) prevention practices and link compliance to CLABSI rates in a national patient safety collaborative. Methods We analyzed data from a national CLABSI prevention program. Adult ICUs participating in the program submitted their CLABSI rates and a Team Checkup Tool (TCT) on a monthly basis. The TCT responses provided self-reported perceptions about how reliably the unit team performed the evidence-based practices in the previous month. Monthly data were aggregated into quarters for the analysis. We analyzed a total of 2775 ICU quarters during the program. Results Chlorhexidine skin preparation and hand hygiene had the highest adherence. Avoidance of the femoral site and removal of unnecessary lines had the lowest compliance. Regression results showed that consistent performance of all practices was significantly associated with lower CLABSI rates. In terms of each practice's independent effect, femoral site avoidance for line placement and removal of unnecessary lines were independently associated with lower CLABSI rates after controlling for other factors. Conclusion Our findings suggest that uptake of the 2 low-compliance practices, avoidance of the femoral site and removal of unnecessary lines, is important for reducing CLABSI rates in conjunction with other practices. |
| doi_str_mv | 10.1016/j.ajic.2014.05.010 |
| format | Article |
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Methods We analyzed data from a national CLABSI prevention program. Adult ICUs participating in the program submitted their CLABSI rates and a Team Checkup Tool (TCT) on a monthly basis. The TCT responses provided self-reported perceptions about how reliably the unit team performed the evidence-based practices in the previous month. Monthly data were aggregated into quarters for the analysis. We analyzed a total of 2775 ICU quarters during the program. Results Chlorhexidine skin preparation and hand hygiene had the highest adherence. Avoidance of the femoral site and removal of unnecessary lines had the lowest compliance. Regression results showed that consistent performance of all practices was significantly associated with lower CLABSI rates. In terms of each practice's independent effect, femoral site avoidance for line placement and removal of unnecessary lines were independently associated with lower CLABSI rates after controlling for other factors. Conclusion Our findings suggest that uptake of the 2 low-compliance practices, avoidance of the femoral site and removal of unnecessary lines, is important for reducing CLABSI rates in conjunction with other practices.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2014.05.010</identifier><identifier>PMID: 25239709</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Administration, Intravenous - adverse effects ; Bacteremia - epidemiology ; Bacteremia - prevention & control ; Catheter-Related Infections - epidemiology ; Catheter-Related Infections - prevention & control ; Catheterization, Central Venous - methods ; Central line–associated bloodstream infections ; Chlorhexidine ; Compliance ; Cross Infection - prevention & control ; Disease prevention ; Guideline Adherence ; Guidelines ; Hand Hygiene ; Health Planning Guidelines ; Hospital-acquired infection ; Humans ; Impact analysis ; Infection Control ; Infection Control - methods ; Infectious Disease ; Intensive care unit ; Intensive Care Units ; Nosocomial infections ; Patient Safety ; Perceptions ; Practice Patterns, Physicians ; Self Report</subject><ispartof>American journal of infection control, 2014-10, Vol.42 (10), p.S191-S196</ispartof><rights>Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>2014 Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Mosby-Year Book, Inc. Oct 2014</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c516t-b0c117885152526a2dbb4dc5b5032105ec8ba7fc13339c4778f02c95d57da04b3</citedby><cites>FETCH-LOGICAL-c516t-b0c117885152526a2dbb4dc5b5032105ec8ba7fc13339c4778f02c95d57da04b3</cites><orcidid>0000-0003-2043-6461</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.ajic.2014.05.010$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3536,27903,27904,45974</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25239709$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hsu, Yea-Jen, PhD, MHA</creatorcontrib><creatorcontrib>Weeks, Kristina, DrPH(c), MHS</creatorcontrib><creatorcontrib>Yang, Ting, PhD</creatorcontrib><creatorcontrib>Sawyer, Melinda D., MSN, RN, CNS-BC</creatorcontrib><creatorcontrib>Marsteller, Jill A., PhD, MPP</creatorcontrib><title>Impact of self-reported guideline compliance: Bloodstream infection prevention in a national collaborative</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>Background We sought to examine self-reported compliance with 5 evidence-based central line–associated bloodstream infection (CLABSI) prevention practices and link compliance to CLABSI rates in a national patient safety collaborative. Methods We analyzed data from a national CLABSI prevention program. Adult ICUs participating in the program submitted their CLABSI rates and a Team Checkup Tool (TCT) on a monthly basis. The TCT responses provided self-reported perceptions about how reliably the unit team performed the evidence-based practices in the previous month. Monthly data were aggregated into quarters for the analysis. We analyzed a total of 2775 ICU quarters during the program. Results Chlorhexidine skin preparation and hand hygiene had the highest adherence. Avoidance of the femoral site and removal of unnecessary lines had the lowest compliance. Regression results showed that consistent performance of all practices was significantly associated with lower CLABSI rates. In terms of each practice's independent effect, femoral site avoidance for line placement and removal of unnecessary lines were independently associated with lower CLABSI rates after controlling for other factors. Conclusion Our findings suggest that uptake of the 2 low-compliance practices, avoidance of the femoral site and removal of unnecessary lines, is important for reducing CLABSI rates in conjunction with other practices.</description><subject>Administration, Intravenous - adverse effects</subject><subject>Bacteremia - epidemiology</subject><subject>Bacteremia - prevention & control</subject><subject>Catheter-Related Infections - epidemiology</subject><subject>Catheter-Related Infections - prevention & control</subject><subject>Catheterization, Central Venous - methods</subject><subject>Central line–associated bloodstream infections</subject><subject>Chlorhexidine</subject><subject>Compliance</subject><subject>Cross Infection - prevention & control</subject><subject>Disease prevention</subject><subject>Guideline Adherence</subject><subject>Guidelines</subject><subject>Hand Hygiene</subject><subject>Health Planning Guidelines</subject><subject>Hospital-acquired infection</subject><subject>Humans</subject><subject>Impact analysis</subject><subject>Infection Control</subject><subject>Infection Control - methods</subject><subject>Infectious Disease</subject><subject>Intensive care unit</subject><subject>Intensive Care Units</subject><subject>Nosocomial infections</subject><subject>Patient Safety</subject><subject>Perceptions</subject><subject>Practice Patterns, Physicians</subject><subject>Self Report</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqFkk-L1jAQh4Mo7uvqF_AgBS9eWidJk7Yigi7-WVjwoJ5DmkwlNW1q0r6w395031VhD3rKBJ7fkMkzhDylUFGg8uVY6dGZigGtKxAVULhHDlSwpuSsk_fJAWgnSykEPyOPUhoBoONSPCRnTDDeNdAdyHg5LdqsRRiKhH4oIy4hrmiL75uz6N2MhQnT4p2eDb4q3vkQbFoj6qlw84BmdWEulohHnG9KNxe6mPVea5-j3us-xHw_4mPyYNA-4ZPb85x8-_D-68Wn8urzx8uLt1elEVSuZQ-G0qZtRZ5EMKmZ7fvaGtEL4IyCQNP2uhkM5Zx3pm6adgBmOmFFYzXUPT8nL059lxh-bphWNblkML9kxrAlRSVjIFrG2P9RIWsuOIUdfX4HHcMW85A3lOwotKLNFDtRJoaUIg5qiW7S8VpRULs0NapdmtqlKRAqS8uhZ7ett35C-yfy21IGXp8AzN92dBhVMg6zEOtiVqBscP_u_-ZO3GSxzmj_A68x_Z1DJaZAfdnXZt8aWgO0wBv-C-KHvHc</recordid><startdate>20141001</startdate><enddate>20141001</enddate><creator>Hsu, Yea-Jen, PhD, MHA</creator><creator>Weeks, Kristina, DrPH(c), MHS</creator><creator>Yang, Ting, PhD</creator><creator>Sawyer, Melinda D., MSN, RN, CNS-BC</creator><creator>Marsteller, Jill A., PhD, MPP</creator><general>Elsevier Inc</general><general>Mosby-Year Book, Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>ASE</scope><scope>FPQ</scope><scope>K6X</scope><orcidid>https://orcid.org/0000-0003-2043-6461</orcidid></search><sort><creationdate>20141001</creationdate><title>Impact of self-reported guideline compliance: Bloodstream infection prevention in a national collaborative</title><author>Hsu, Yea-Jen, PhD, MHA ; Weeks, Kristina, DrPH(c), MHS ; Yang, Ting, PhD ; Sawyer, Melinda D., MSN, RN, CNS-BC ; Marsteller, Jill A., PhD, MPP</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-b0c117885152526a2dbb4dc5b5032105ec8ba7fc13339c4778f02c95d57da04b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Administration, Intravenous - adverse effects</topic><topic>Bacteremia - epidemiology</topic><topic>Bacteremia - prevention & control</topic><topic>Catheter-Related Infections - epidemiology</topic><topic>Catheter-Related Infections - prevention & control</topic><topic>Catheterization, Central Venous - methods</topic><topic>Central line–associated bloodstream infections</topic><topic>Chlorhexidine</topic><topic>Compliance</topic><topic>Cross Infection - prevention & control</topic><topic>Disease prevention</topic><topic>Guideline Adherence</topic><topic>Guidelines</topic><topic>Hand Hygiene</topic><topic>Health Planning Guidelines</topic><topic>Hospital-acquired infection</topic><topic>Humans</topic><topic>Impact analysis</topic><topic>Infection Control</topic><topic>Infection Control - methods</topic><topic>Infectious Disease</topic><topic>Intensive care unit</topic><topic>Intensive Care Units</topic><topic>Nosocomial infections</topic><topic>Patient Safety</topic><topic>Perceptions</topic><topic>Practice Patterns, Physicians</topic><topic>Self Report</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hsu, Yea-Jen, PhD, MHA</creatorcontrib><creatorcontrib>Weeks, Kristina, DrPH(c), MHS</creatorcontrib><creatorcontrib>Yang, Ting, PhD</creatorcontrib><creatorcontrib>Sawyer, Melinda D., MSN, RN, CNS-BC</creatorcontrib><creatorcontrib>Marsteller, Jill A., PhD, MPP</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>British Nursing Index</collection><collection>British Nursing Index (BNI) (1985 to Present)</collection><collection>British Nursing Index</collection><jtitle>American journal of infection control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hsu, Yea-Jen, PhD, MHA</au><au>Weeks, Kristina, DrPH(c), MHS</au><au>Yang, Ting, PhD</au><au>Sawyer, Melinda D., MSN, RN, CNS-BC</au><au>Marsteller, Jill A., PhD, MPP</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of self-reported guideline compliance: Bloodstream infection prevention in a national collaborative</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2014-10-01</date><risdate>2014</risdate><volume>42</volume><issue>10</issue><spage>S191</spage><epage>S196</epage><pages>S191-S196</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>Background We sought to examine self-reported compliance with 5 evidence-based central line–associated bloodstream infection (CLABSI) prevention practices and link compliance to CLABSI rates in a national patient safety collaborative. Methods We analyzed data from a national CLABSI prevention program. Adult ICUs participating in the program submitted their CLABSI rates and a Team Checkup Tool (TCT) on a monthly basis. The TCT responses provided self-reported perceptions about how reliably the unit team performed the evidence-based practices in the previous month. Monthly data were aggregated into quarters for the analysis. We analyzed a total of 2775 ICU quarters during the program. Results Chlorhexidine skin preparation and hand hygiene had the highest adherence. Avoidance of the femoral site and removal of unnecessary lines had the lowest compliance. Regression results showed that consistent performance of all practices was significantly associated with lower CLABSI rates. In terms of each practice's independent effect, femoral site avoidance for line placement and removal of unnecessary lines were independently associated with lower CLABSI rates after controlling for other factors. Conclusion Our findings suggest that uptake of the 2 low-compliance practices, avoidance of the femoral site and removal of unnecessary lines, is important for reducing CLABSI rates in conjunction with other practices.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25239709</pmid><doi>10.1016/j.ajic.2014.05.010</doi><orcidid>https://orcid.org/0000-0003-2043-6461</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Administration, Intravenous - adverse effects Bacteremia - epidemiology Bacteremia - prevention & control Catheter-Related Infections - epidemiology Catheter-Related Infections - prevention & control Catheterization, Central Venous - methods Central line–associated bloodstream infections Chlorhexidine Compliance Cross Infection - prevention & control Disease prevention Guideline Adherence Guidelines Hand Hygiene Health Planning Guidelines Hospital-acquired infection Humans Impact analysis Infection Control Infection Control - methods Infectious Disease Intensive care unit Intensive Care Units Nosocomial infections Patient Safety Perceptions Practice Patterns, Physicians Self Report |
| title | Impact of self-reported guideline compliance: Bloodstream infection prevention in a national collaborative |
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