Reducing Staphylococcus aureus bloodstream infections associated with peripheral intravenous cannulae: successful implementation of a care bundle at a large Australian health service
| Autor: | Susan C McLellan, Deborah Rhodes, P. Guerra, Stacey Aitchison, Leon J Worth, Allen C. Cheng, Kerrie Watson, D. Karanfilovska, Pauline Bass |
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| Rok vydání: | 2016 |
| Předmět: |
Microbiology (medical)
Staphylococcus aureus medicine.medical_specialty Psychological intervention Audit 030501 epidemiology Staphylococcal infections Sepsis 03 medical and health sciences 0302 clinical medicine Health care medicine Cannula Humans Infection control 030212 general & internal medicine Intensive care medicine Infection Control business.industry Australia Health services research General Medicine Health Services Staphylococcal Infections medicine.disease Infectious Diseases Catheter-Related Infections Health Services Research 0305 other medical science business Patient Care Bundles |
| Zdroj: | Journal of Hospital Infection. 94:86-91 |
| ISSN: | 0195-6701 |
| DOI: | 10.1016/j.jhin.2016.05.020 |
| Popis: | Healthcare-associated Staphylococcus aureus bacteraemia (HA-SAB) results in morbidity, mortality, and increased healthcare costs, and these infections are frequently regarded as preventable.To implement a multi-modal prevention programme for improved processes regarding peripheral intravenous cannula (PIVC) insertion and maintenance, in order to reduce PIVC-associated HA-SAB events in a large Australian health service.Baseline clinical practice was evaluated for a 12-month pre-intervention period. Measures to reduce HA-SAB risk were introduced between January and September 2013: staff education, improved documentation (including phlebitis scoring), and availability of standardized equipment. Post-intervention auditing was performed during the 27 months following intervention. Baseline and post-intervention HA-SAB and PIVC-associated infection rates were compared. Interrupted time-series and Bayesian change-point analyses were applied to determine the impact of interventions and timing of change.Significantly improved documentation regarding PIVC insertion and management was observed in the post-intervention period, with fewer PIVCs left in situ for ≥4 days (2.6 vs 6.9%, P0.05). During the baseline period a total of 68 HA-SAB events occurred [1.01/10,000 occupied bed-days (OBDs)] and 24 were PIVC-associated (35% of total, rate 0.39 per 10,000 OBDs). In the post-intervention period, a total of 83 HA-SAB events occurred (0.99 per 10,000 OBDs) and 12 were PIVC-associated (14.4% of total, rate 0.14 per 10,000 OBDs). PIVC-associated SAB rates were 63% lower in the post-intervention period compared to baseline (P=0.018) with a change point observed following full bundle implementation in October 2013.A successful multi-modal hospital-wide campaign was introduced to reduce PIVC-associated SAB rates. Evaluation of cost-effectiveness and sustainability is required. |
| Databáze: | OpenAIRE |
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