降低中央管路相关血流感染(CLABSI)质量改进项目后重症监护室的成果。

IF 4.6 Q2 MATERIALS SCIENCE, BIOMATERIALS ACS Applied Bio Materials Pub Date : 2024-10-01 Epub Date: 2024-09-11 DOI:10.1080/03007995.2024.2401097
Ronald Harris, Nitin L Mehdiratta, Morgan A Rosser, Anand M Chowdhury, Becky A Smith, Karthik Raghunathan, Vijay Krishnamoorthy
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引用次数: 0

摘要

背景:中心管路相关血流感染(CLABSI)是住院患者的重大并发症。目前已有几种不同的方法用于降低 CLABSI:本研究旨在:(1) 描述用于分析和降低一家四级医疗机构外科重症监护病房(SICU)CLABSI 感染率的系统方法(CLABSI 减少捆绑疗法);(2) 与六家未暴露的医疗系统重症监护病房相比,研究捆绑疗法对 SICU CLABSI 感染率的影响:方法:对美国东南部单一医疗系统中中心静脉输液天数大于 0 天的 14,022 名成年患者进行回顾性分析。CLABSI 干预捆绑包于 2021 年 7 月创建并实施。我们进行了单次和多次中断时间序列分析,以评估 CLABSI 干预包在干预前和干预后对 SICU(与对照 ICU 相比)CLABSI 感染率的影响。辅助分析检验了捆绑计划与重症监护病房死亡率和住院时间的关系:结果:与对照 ICU 相比,CLABSI 套件在降低 SICU CLABSI 感染率方面具有显著的立竿见影的效果。与对照 ICU 相比,干预后 CLABSI 感染率的斜率没有明显变化。减少CLABSI感染捆绑措施与重症监护病房的住院时间和SICU的死亡率没有明显关系:结论:与未暴露的重症监护病房相比,CLABSI捆绑干预措施可立即降低重症监护病房的CLABSI发生率。简单的捆绑干预措施可以有效降低外科重症监护病房的 CLABSI 发生率。
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ICU outcomes following a Central Line Associated Blood Stream Infections (CLABSI) reduction quality improvement project.

Background: Central Line Associated Blood Stream Infections (CLABSI) are significant complications for hospitalized patients. Several different approaches have been used to reduce CLABSI.

Objective: This study aimed to (1) describe a systematic approach used to analyze and reduce CLABSI rates in a surgical ICU (SICU) at a quaternary care medical facility (CLABSI reduction bundle) and (2) examine the association of the bundle on CLABSI rates in the SICU, compared to six unexposed health system ICUs.

Methods: Retrospective analysis of 14,022 adult patients with > 0 central line days within a single health system in the southeastern United States. The CLABSI intervention bundle was created and implemented in July 2021. Single and multiple interrupted time series analyses were performed to assess the impact of the CLABSI bundle on CLABSI rate in SICU (compared to control ICUs) pre- and post-intervention. Secondary analyses examined the association of the bundle with ICU mortality and length of stay.

Results: The CLABSI bundle was associated with a significant immediate effect in reducing the CLABSI rate in the SICU compared with control ICUs. There was no significant change in the slope of CLABSI rate post-intervention, compared to control ICUs. There was no significant association of the CLABSI reduction bundle on ICU length of stay or mortality in the SICU.

Conclusion: The CLABSI bundle was associated with an immediate reduction in CLABSI incidence in the SICU compared to unexposed ICUs. A simple, bundled intervention can be effective in reducing CLABSI incidence in a surgical ICU population.

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来源期刊
ACS Applied Bio Materials
ACS Applied Bio Materials Chemistry-Chemistry (all)
CiteScore
9.40
自引率
2.10%
发文量
464
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