Using the agile implementation model to reduce central line–associated bloodstream infections
Central line–associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that...
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Veröffentlicht in: | American journal of infection control 2019-01, Vol.47 (1), p.33-37 |
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container_title | American journal of infection control |
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creator | Azar, Jose Kelley, Kristen Dunscomb, Jennifer Perkins, Anthony Wang, Yun Beeler, Cole Dbeibo, Lana Webb, Douglas Stevens, Larry Luektemeyer, Mark Kara, Areeba Nagy, Ryan Solid, Craig A. Boustani, Malaz |
description | Central line–associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI.
We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017.
The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable.
Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility. |
doi_str_mv | 10.1016/j.ajic.2018.07.008 |
format | Article |
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We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017.
The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable.
Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.</description><identifier>ISSN: 0196-6553</identifier><identifier>EISSN: 1527-3296</identifier><identifier>DOI: 10.1016/j.ajic.2018.07.008</identifier><identifier>PMID: 30201414</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Catheter-Related Infections - prevention & control ; Catheterization, Central Venous - adverse effects ; Central line–associated bloodstream infections ; Humans ; Implementation science ; Indiana ; Infection Control - methods ; Patient Care Bundles - methods ; Quality improvement ; Sepsis - prevention & control ; Tertiary Care Centers</subject><ispartof>American journal of infection control, 2019-01, Vol.47 (1), p.33-37</ispartof><rights>2018 Association for Professionals in Infection Control and Epidemiology, Inc.</rights><rights>Copyright © 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c400t-dfbafe593dffa572ddca75101d41d043235f15e4e2da45e4240f3015511ac2583</citedby><cites>FETCH-LOGICAL-c400t-dfbafe593dffa572ddca75101d41d043235f15e4e2da45e4240f3015511ac2583</cites><orcidid>0000-0002-1127-3085</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S019665531830751X$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30201414$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Azar, Jose</creatorcontrib><creatorcontrib>Kelley, Kristen</creatorcontrib><creatorcontrib>Dunscomb, Jennifer</creatorcontrib><creatorcontrib>Perkins, Anthony</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Beeler, Cole</creatorcontrib><creatorcontrib>Dbeibo, Lana</creatorcontrib><creatorcontrib>Webb, Douglas</creatorcontrib><creatorcontrib>Stevens, Larry</creatorcontrib><creatorcontrib>Luektemeyer, Mark</creatorcontrib><creatorcontrib>Kara, Areeba</creatorcontrib><creatorcontrib>Nagy, Ryan</creatorcontrib><creatorcontrib>Solid, Craig A.</creatorcontrib><creatorcontrib>Boustani, Malaz</creatorcontrib><title>Using the agile implementation model to reduce central line–associated bloodstream infections</title><title>American journal of infection control</title><addtitle>Am J Infect Control</addtitle><description>Central line–associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI.
We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017.
The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable.
Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.</description><subject>Catheter-Related Infections - prevention & control</subject><subject>Catheterization, Central Venous - adverse effects</subject><subject>Central line–associated bloodstream infections</subject><subject>Humans</subject><subject>Implementation science</subject><subject>Indiana</subject><subject>Infection Control - methods</subject><subject>Patient Care Bundles - methods</subject><subject>Quality improvement</subject><subject>Sepsis - prevention & control</subject><subject>Tertiary Care Centers</subject><issn>0196-6553</issn><issn>1527-3296</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kLtO7DAURS0EguHxAxRXLmkSju04yUg0CPGSkGigtjz2MXjkxHPtDNLt-Af-kC_Bo4FbUu3i7LWlswg5ZVAzYO35stZLb2oOrK-hqwH6HTJjkneV4PN2l8yAzduqlVIckMOclwAwF63cJwcCCtSwZkbUc_bjC51ekeoXH5D6YRVwwHHSk48jHaLFQKdIE9q1QWrKJelAgx_x8_1D5xyN1xNauggx2jwl1AP1o0Oz4fMx2XM6ZDz5ziPyfHP9dHVXPTze3l9dPlSmAZgq6xbaoZwL65yWHbfW6E6WL23DLDSCC-mYxAa51U1J3oATwKRkTBsue3FEzra7qxT_rjFPavDZYAh6xLjOijPgQvQ9k6XKt1WTYs4JnVolP-j0TzFQG7FqqTZi1Uasgk4VsQX6872_Xgxo_yM_JkvhYlvA8uWbx6Sy8TgatD4VF8pG_9v-Fwgei80</recordid><startdate>201901</startdate><enddate>201901</enddate><creator>Azar, Jose</creator><creator>Kelley, Kristen</creator><creator>Dunscomb, Jennifer</creator><creator>Perkins, Anthony</creator><creator>Wang, Yun</creator><creator>Beeler, Cole</creator><creator>Dbeibo, Lana</creator><creator>Webb, Douglas</creator><creator>Stevens, Larry</creator><creator>Luektemeyer, Mark</creator><creator>Kara, Areeba</creator><creator>Nagy, Ryan</creator><creator>Solid, Craig A.</creator><creator>Boustani, Malaz</creator><general>Elsevier 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><orcidid>https://orcid.org/0000-0002-1127-3085</orcidid></search><sort><creationdate>201901</creationdate><title>Using the agile implementation model to reduce central line–associated bloodstream infections</title><author>Azar, Jose ; Kelley, Kristen ; Dunscomb, Jennifer ; Perkins, Anthony ; Wang, Yun ; Beeler, Cole ; Dbeibo, Lana ; Webb, Douglas ; Stevens, Larry ; Luektemeyer, Mark ; Kara, Areeba ; Nagy, Ryan ; Solid, Craig A. ; Boustani, Malaz</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c400t-dfbafe593dffa572ddca75101d41d043235f15e4e2da45e4240f3015511ac2583</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Catheter-Related Infections - prevention & control</topic><topic>Catheterization, Central Venous - adverse effects</topic><topic>Central line–associated bloodstream infections</topic><topic>Humans</topic><topic>Implementation science</topic><topic>Indiana</topic><topic>Infection Control - methods</topic><topic>Patient Care Bundles - methods</topic><topic>Quality improvement</topic><topic>Sepsis - prevention & control</topic><topic>Tertiary Care Centers</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Azar, Jose</creatorcontrib><creatorcontrib>Kelley, Kristen</creatorcontrib><creatorcontrib>Dunscomb, Jennifer</creatorcontrib><creatorcontrib>Perkins, Anthony</creatorcontrib><creatorcontrib>Wang, Yun</creatorcontrib><creatorcontrib>Beeler, Cole</creatorcontrib><creatorcontrib>Dbeibo, Lana</creatorcontrib><creatorcontrib>Webb, Douglas</creatorcontrib><creatorcontrib>Stevens, Larry</creatorcontrib><creatorcontrib>Luektemeyer, Mark</creatorcontrib><creatorcontrib>Kara, Areeba</creatorcontrib><creatorcontrib>Nagy, Ryan</creatorcontrib><creatorcontrib>Solid, Craig A.</creatorcontrib><creatorcontrib>Boustani, Malaz</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><jtitle>American journal of infection control</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Azar, Jose</au><au>Kelley, Kristen</au><au>Dunscomb, Jennifer</au><au>Perkins, Anthony</au><au>Wang, Yun</au><au>Beeler, Cole</au><au>Dbeibo, Lana</au><au>Webb, Douglas</au><au>Stevens, Larry</au><au>Luektemeyer, Mark</au><au>Kara, Areeba</au><au>Nagy, Ryan</au><au>Solid, Craig A.</au><au>Boustani, Malaz</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Using the agile implementation model to reduce central line–associated bloodstream infections</atitle><jtitle>American journal of infection control</jtitle><addtitle>Am J Infect Control</addtitle><date>2019-01</date><risdate>2019</risdate><volume>47</volume><issue>1</issue><spage>33</spage><epage>37</epage><pages>33-37</pages><issn>0196-6553</issn><eissn>1527-3296</eissn><abstract>Central line–associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI.
We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017.
The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable.
Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>30201414</pmid><doi>10.1016/j.ajic.2018.07.008</doi><tpages>5</tpages><orcidid>https://orcid.org/0000-0002-1127-3085</orcidid><oa>free_for_read</oa></addata></record> |
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subjects | Catheter-Related Infections - prevention & control Catheterization, Central Venous - adverse effects Central line–associated bloodstream infections Humans Implementation science Indiana Infection Control - methods Patient Care Bundles - methods Quality improvement Sepsis - prevention & control Tertiary Care Centers |
title | Using the agile implementation model to reduce central line–associated bloodstream infections |
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