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Multifaceted ICU intervention decreases CLABSIs
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By using a multifaceted intervention, clinicians at intensive care units in diverse settings can achieve a substantial decrease in the global morbidity and mortality associated with central line-associated bloodstream infections, according to recent findings.
“Some of the most promising efforts to reduce CLABSIs come from the field of patient safety,” researchers wrote in Infection Control and Hospital Epidemiology. “One notable example is the Keystone ICU Project, a cohort collaborative improvement project that used a multifaceted intervention involving a checklist of evidence-based practices to prevent CLABSI, a comprehensive safety program to address culture change, and performance feedback.”
Asad Latif, MD, MPH, of the Armstrong Institute for Patient Safety and Quality at Johns Hopkins Medicine, and colleagues expanded the Keystone Project to the Middle East, implementing a bundled intervention at 18 ICUs from seven hospitals in the Emirate of Abu Dhabi. The intervention consisted of the same three elements:
- a CLABSI prevention program aimed at promoting physician use of evidence-based infection prevention recommendations from the CDC;
- a comprehensive unit-based safety program designed to improve the culture of safety and teamwork; and
- an assessment of and feedback on monthly CLABSI infection rate data shared by the safety teams, senior leaders and ICU staff.
The researchers defined the study’s main outcome measure as the quarterly rate of CLABSIs.
After adjustment for random effects at the ICU and hospital levels, the researchers found that the ICUs achieved a 38% reduction in CLABSI rates. In addition, there was a 39% increase in the number of ICUs to achieve a CLABSI rate of less than 1 infection per 1,000 catheter-days.
According to the researchers, these findings demonstrate that hospitals in the Middle East could benefit from this multifaceted intervention, which already has been successfully introduced in the United States, Spain and England.
“These results suggest that ICUs in disparate settings across the world could use this program and achieve similar results, significantly reducing the global morbidity, mortality and excess costs associated with CLABSI,” the researchers wrote. “This collaborative could also serve as a model for future efforts to broadly reduce other types of preventable harm in the Middle East.”
Disclosure: The researchers report no relevant disclosures.
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