Stepwise introduction of the 'Best Care Always' central-line-associated bloodstream infection prevention bundle in a network of South African hospitals.
J Hosp Infect
; 97(1): 86-92, 2017 Sep.
Article
en En
| MEDLINE
| ID: mdl-28549778
ABSTRACT
BACKGROUND:
Healthcare-associated infection (HCAI) remains a major international problem.AIM:
The 'Best Care Always!' (BCA) campaign was launched in South Africa to reduce preventable HCAI, including central-line-associated bloodstream infection (CLABSI).METHODS:
The intervention took place in 43 Netcare Private Hospitals, increasing later to 49 with 958 intensive care units (ICUs) and 439 high-care (HC) beds and 1207 ICUs and 493 HC beds, respectively. Phase 1, April 2010 to March 2011, ICU infection prevention and control (IPC) nurse-driven change commitment from management and doctors and training of IPC nurses. Bundle compliance and infections per 1000 central-line-days were incorporated as standard IPC measures and captured monthly. Phase 2, April 2011 to March 2012, breakthrough collaborativemethod:
multiple regional learning sessions for nursing leaders, IPC nurses and unit managers. Phase 3, April 2012 to May 2016 sustained goal-setting, benchmarks, ongoing audits.FINDINGS:
A total of 1,119,558 central-line-days were recorded. Bundle compliance improved significantly from a mean of 73.1% [standard deviation (SD) 11.2; range 40.6-81.7%] in Phase 1 to a mean of 90.5% (SD 4.7; range 76.5-97.2%) in Phase 3 (P = 0.0004). The CLABSI rate declined significantly from a mean of 3.55 (SD 0.82; range 2.54-5.78) per 1000 central-line-days in Phase 1 to a mean of 0.13 (SD 0.09; range 0-0.33) (P < 0.0001).CONCLUSION:
This intervention, the first of its kind in South Africa, through considerable motivation and education, and through competition between hospitals resulted in significant decreases in CLABSI.Palabras clave
Texto completo:
1
Colección:
01-internacional
Banco de datos:
MEDLINE
Asunto principal:
Cateterismo Venoso Central
/
Control de Infecciones
/
Sepsis
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Infecciones Relacionadas con Catéteres
/
Paquetes de Atención al Paciente
Tipo de estudio:
Incidence_studies
/
Prognostic_studies
/
Risk_factors_studies
Límite:
Humans
País/Región como asunto:
Africa
Idioma:
En
Revista:
J Hosp Infect
Año:
2017
Tipo del documento:
Article