Implementation and long-term efficacy of a multifaceted intervention to reduce central line-associated bloodstream infections in intensive care units of a low-middle-income country - 19/06/24
, Wajid Ali, MD b, c, Sohail Haleem, MBBS d, Faisal Mahmood, MD e, Tahir Munir, M. Phil a, Nazleen Virani, BSN f, Hamza Khan, MD b, Maqbool Qadir, MD g, Rozina Roshan, BSN f, Khairunnissa Hooda, BSN h, Nadeem Mustafa Khan i, Afia Zafar, MBBS j, Peter Pronovost, MD, PhD kResumen |
Background |
Central line-associated bloodstream infections (CLABSIs) pose a significant risk to critically ill patients, particularly in intensive care units (ICU), and are a significant cause of hospital-acquired infections. We investigated whether implementation of a multifaceted intervention was associated with reduced incidence of CLABSIs.
Methods |
This was a prospective cohort study over nine years. We implemented a bundled intervention approach to prevent CLABSIs, consisting of a comprehensive unit-based safety program (CUSP). The program was implemented in the Neonatal ICU, Medical ICU, and Surgical ICU departments at the Aga Khan University Hospital in Pakistan.
Results |
The three intervention ICUs combined were associated with an overall 36% reduction in CLABSI rates and a sustained reduction in CLABSI rates for > a year (5 quarters). The Neonatal ICU experienced a decrease of 77% in CLABSI rates lasting ∼1 year (4 quarters). An attendance rate above 88% across all stakeholder groups in each CUSP meeting correlated with a better and more sustained infection reduction.
Conclusions |
Our multifaceted approach using the CUSP model was associated with reduced CLABSI-associated morbidity and mortality in resource-limited settings. Our findings suggest that a higher attendance rate (>85%) at meetings may be necessary to achieve sustained effects post-intervention.
El texto completo de este artículo está disponible en PDF.Highlights |
• | Successful 36% reduction in CLABSI rates using CUSP in intervention LMIC ICU settings. |
• | Association noted between stakeholder attendance and extent of reduction in CLABSI rates. |
• | Reduction in CLABSI rates sustained for 5 quarters after stopping the CUSP program. |
Key Words : Quality improvement, Comprehensive unit-based safety program, Central-line infections, Infection prevention, Implementation research
Esquema
| Funding/support: This work received support from a Faculty Pilot Grant in Global Health from the Johns Hopkins Center for Global Health. |
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| Conflicts of interest: None to report. |
Vol 52 - N° 7
P. 819-826 - juillet 2024 Regresar al número
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