Title |
Prevention of Central Line–Associated Bloodstream Infections Through Quality Improvement Interventions: A Systematic Review and Meta-analysis
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Published in |
Clinical Infectious Diseases, April 2014
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DOI | 10.1093/cid/ciu239 |
Pubmed ID | |
Authors |
Koen Blot, Jochen Bergs, Dirk Vogelaers, Stijn Blot, Dominique Vandijck |
Abstract |
This systematic review and meta-analysis examines the impact of quality improvement interventions on central line-associated bloodstream infections in adult intensive care units. Studies were identified through Medline and manual searches (1995-June 2012). Random-effects meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Meta-regression assessed the impact of bundle/checklist interventions and high baseline rates on intervention effect. Forty-one before-after studies identified an infection rate decrease (OR, 0.39 [95% CI, .33-.46]; P < .001). This effect was more pronounced for trials implementing a bundle or checklist approach (P = .03). Furthermore, meta-analysis of 6 interrupted time series studies revealed an infection rate reduction 3 months postintervention (OR, 0.30 [95% CI, .10-.88]; P = .03). There was no difference in infection rates between studies with low or high baseline rates (P = .18). These results suggest that quality improvement interventions contribute to the prevention of central line-associated bloodstream infections. Implementation of care bundles and checklists appears to yield stronger risk reductions. |
X Demographics
Geographical breakdown
Country | Count | As % |
---|---|---|
Spain | 2 | 25% |
United Kingdom | 1 | 13% |
United States | 1 | 13% |
Belgium | 1 | 13% |
Unknown | 3 | 38% |
Demographic breakdown
Type | Count | As % |
---|---|---|
Members of the public | 4 | 50% |
Scientists | 2 | 25% |
Practitioners (doctors, other healthcare professionals) | 2 | 25% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
---|---|---|
United Kingdom | 2 | <1% |
Brazil | 1 | <1% |
Canada | 1 | <1% |
Belgium | 1 | <1% |
Denmark | 1 | <1% |
United States | 1 | <1% |
Unknown | 203 | 97% |
Demographic breakdown
Readers by professional status | Count | As % |
---|---|---|
Student > Master | 31 | 15% |
Student > Postgraduate | 25 | 12% |
Student > Bachelor | 23 | 11% |
Researcher | 22 | 10% |
Other | 17 | 8% |
Other | 43 | 20% |
Unknown | 49 | 23% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 76 | 36% |
Nursing and Health Professions | 45 | 21% |
Agricultural and Biological Sciences | 6 | 3% |
Immunology and Microbiology | 4 | 2% |
Social Sciences | 4 | 2% |
Other | 18 | 9% |
Unknown | 57 | 27% |