Eliminating Central Line–Associated Bloodstream Infections: A National Patient Safety Imperative

Berenholtz, Sean M.; Lubomski, Lisa H.; Weeks, Kristina; Goeschel, Christine A.; Marsteller, Jill A.; Pham, Julius Cuong; Sawyer, Melinda; Thompson, David A.; Winters, Bradford D.; Cosgrove, Sara E.; Yang, Ting; Louis, Thomas A.; Lucas, Barbara Meyer; George, Christine T.; Watson, Sam R.; Albert-Lesher, Mariana I; Andre, Justin R. St.; Combes, John; Bohr, Deborah; Hines, Stephen C.; Battles, James B; Pronovost, Peter J.

doi:10.1086/674384

Cited by 112 publications

(86 citation statements)

References 17 publications

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“…[33][34][35] As in similar cases, this allowed us to learn both as institutions and as a network. The Model for Improvement served as an excellent basis to enhance or initiate quality improvement work among network partners and ultimately to change outcomes.…”

Section: Discussionmentioning

confidence: 95%

Surgical Site Infection Reduction by the Solutions for Patient Safety Hospital Engagement Network

Schaffzin¹,

Harte

Marquette

et al. 2015

Pediatrics

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OBJECTIVE: Surgical site infections (SSIs) negatively affect patients and the health care system. National standards for SSI prevention do not exist in pediatric settings. We sought to reduce SSI-related harm by implementing a prevention bundle through the Solutions for Patient Safety (SPS) national hospital engagement network.METHODS: Our study period was January 2011 to December 2013. We formed a national workgroup of content and quality improvement experts. We focused on 3 procedure types at high risk for SSIs: cardiothoracic, neurosurgical shunt, and spinal fusion surgeries. We used the Model for Improvement methodology and the Centers for Disease Control and Prevention SSI definition. After literature review and consultation with experts, we distributed a recommended bundle among network partners. Institutions were permitted to adopt all or part of the bundle and reported local bundle adherence and SSI rates monthly. Our learning network used webinars, discussion boards, targeted leader messaging, and in-person learning sessions.RESULTS: Recommended bundle elements encompassed proper preoperative bathing, intraoperative skin antisepsis, and antibiotic delivery. Within 6 months, the network achieved 96.7% reliability among institutions reporting adherence data. A 21% reduction in SSI rate was reported across network hospitals, from a mean baseline rate of 2.5 SSIs per 100 procedures to a mean rate of 1.8 SSIs per 100 procedures. The reduced rate was sustained for 15 months.CONCLUSIONS: Adoption of a SSI prevention bundle with concomitant reliability measurement reduced the network SSI rate. Linking reliability measurement to standardization at an institutional level may lead to safer care.Surgical site infections (SSIs) are common, accounting for nearly one-third of all health care-associated infections among hospitalized adults. 1,2 These infections increase patient morbidity and mortality and pose a high cost burden to the US health care system. [3][4][5] In 1 study, the national SSI rate in children was reported to be 1.8%. 6 Procedures that have been associated with higher SSI rates in children include cardiothoracic, neurosurgical ventricular shunt, and spinal fusion surgeries. Reported rates of infection have large institutional variability: 2.3% to 5% for cardiothoracic, 7-9 5.7% to 10.4% for neurosurgical ventricular shunt, [10][11][12] and 4.4% to 10.2% for spinal fusion surgeries. [13][14][15][16] For this reason, these 3 types of procedures are commonly monitored for SSIs and targeted for SSI reduction.

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Section: Discussionmentioning

confidence: 95%

Surgical Site Infection Reduction by the Solutions for Patient Safety Hospital Engagement Network

Schaffzin¹,

Harte

Marquette

et al. 2015

Pediatrics

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“…The major disadvantage of this technology is the requirement for central venous catheterization, which incurs several risks, the most important of which may be central lineassociated bloodstream infection. 100 …”

Section: Technological Assessmentmentioning

confidence: 99%

Inter-device differences in monitoring for goal-directed fluid therapy

Thiele

Bartels

Gan

2014

Can J Anesth/J Can Anesth

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“…benchmarks not only for healthcare organizations but also for countries [11][12][13][14][15][16]. In addition, SAQ has been used to examine the effectiveness of patient safety programs [2,17,18]. Unfortunately, however, despite huge improvements in patient safety, Korea does not have a validated safety culture measurement tool that can be applied nationally, although some healthcare organizations have developed their own instrument.…”

Section: Introductionmentioning

confidence: 99%

Development of the Safety Attitudes Questionnaire - Korean Version (SAQ-K) and Its Novel Analysis Methods or Safety Managers

Jeong¹

2015

BBIJ

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Eliminating Central Line–Associated Bloodstream Infections: A National Patient Safety Imperative

Cited by 112 publications

References 17 publications

Surgical Site Infection Reduction by the Solutions for Patient Safety Hospital Engagement Network

Surgical Site Infection Reduction by the Solutions for Patient Safety Hospital Engagement Network

Inter-device differences in monitoring for goal-directed fluid therapy

Development of the Safety Attitudes Questionnaire - Korean Version (SAQ-K) and Its Novel Analysis Methods or Safety Managers

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