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Quality improvement interventions reduced CLABSI rate
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The implementation of quality improvement interventions for the prevention of central line-associated bloodstream infections, or CLABSIs, resulted in reduced rates of infection, according to data from a systematic review and meta-analysis.
“Quality improvement interventions appeared equally effective in studies with low and high power or baseline CLABSI rate settings,” researchers from Ghent University in Belgium wrote in Clinical Infectious Diseases. “Further research should assess requirements for successful adaptation of quality improvement interventions … over longer follow-up periods.”
The analysis included 43 studies that were published between 1995 and June 2012, involving 584 ICUs. The studies consisted of 35 before-after studies, seven interrupted time series studies and one controlled before-after study.
In the meta-analysis of the before-after studies, the researchers found reductions in CLABSI rates (OR=0.39; 95% CI, 0.33-0.46). The analysis of the interrupted time series studies also showed a reduction in CLABSI rates 3 months post-intervention (OR=0.3; 95% CI, 0.1-0.88). In a subgroup analysis of the before-after studies, the CLABSI risk reduction was higher in trials that used care bundles or checklists (OR=0.34; 95% CI, 0.27-0.41) than those that did not (OR=0.45; 95% CI, 0.36-0.55).
The researchers also found that higher baseline rates of CLABSI infections, above four CLABSI per 1,000 catheter days (OR=0.37; 95% CI, 0.33-0.46) did not result in larger risk reductions compared with studies with a lower baseline infection rate (OR=0.49; 95% CI, 0.37-0.66).
“This study offers a broad look on the state of current research and applicable interventions, and applies a novel classification system to synthesize evidence for quality improvement initiatives,” the researchers wrote.
Disclosure: One researcher reports financial relationships with Astellas, Pfizer and Tibotec.
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