Using the agile implementation model to reduce central line–associated bloodstream infections - 04/01/19

Doi : 10.1016/j.ajic.2018.07.008

Jose Azar, MD ^a,^b,^c, Kristen Kelley, MPH ^c, Jennifer Dunscomb, MSN, RN ^c, Anthony Perkins, MS ^d, Yun Wang, MD ^c, Cole Beeler, MD ^c,^d, Lana Dbeibo, MD ^c,^d, Douglas Webb, MD ^c, Larry Stevens, MD ^d, Mark Luektemeyer, MD ^c,^d, Areeba Kara, MD, MS ^c,^d, Ryan Nagy, MD ^c,^d, Craig A. Solid, PhD ^e,^⁎ , Malaz Boustani, MD, MPH ^a,^b,^c,^f
^a Indiana Clinical Translational Sciences Institute, Indiana University, Indianapolis, IN
^b Center for Health Innovation and Implementation Science, Indiana University School of Medicine, Indianapolis, IN
^c Indiana University Health, Indianapolis, IN
^d Indiana University School of Medicine, Indianapolis, IN
^e Solid Research Group LLC, St. Paul, MN
^f Regenstrief Institute, Inc., Indianapolis, IN

^⁎Address correspondence to Craig A. Solid, PhD, Solid Research Group LLC, 1668 Portland Ave, St. Paul, MN 55104.Solid Research Group LLC1668 Portland Ave, St. PaulMN55104

Résumé

Background

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.

Methods

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.

Results

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.

Conclusions

Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.

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Key Words : Quality improvement, Implementation science, Central line–associated bloodstream infections

Plan

The implementation process

Study measurement and statistical analysis

Results

Discussion

Conclusions

Conflicts of interest: JA, KK, JD, YW, CB, LD, DW, ML, AK, RN, and MB are employees of Indiana University Health. AP, LS, and CAS report no conflicts of interest relevant to this article.

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Vol 47 - N° 1

P. 33-37 - janvier 2019 Retour au numéro

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Using the agile implementation model to reduce central line–associated bloodstream infections - 04/01/19

Résumé

Background

Methods

Results

Conclusions

Plan

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