Advanced search
Start date
Betweenand
Related content
(Reference retrieved automatically from Web of Science through information on FAPESP grant and its corresponding number as mentioned in the publication by the authors.)

Implementation of tailored interventions in a statewide programme to reduce central line-associated bloodstream infections

Full text
Author(s):
Assis, D. B. [1] ; Madalosso, G. [1] ; Padoveze, M. C. [2] ; Lobo, R. D. [3] ; Oliveira, M. S. [3] ; Boszczowski, I [3] ; Singer, J. M. [4] ; Levin, A. S. [5, 6, 2, 7]
Total Authors: 8
Affiliation:
[1] Sao Paulo State Hlth Dept, Ctr Dis Control, Ctr Epidemiol Surveillance Prof Alexandre Vranjac, Div Nosocomial Infect, Sao Paulo - Brazil
[2] Univ Sao Paulo, Sch Nursing, Dept Collect Hlth Nursing, Sao Paulo - Brazil
[3] Univ Sao Paulo, Hosp Clin, Dept Infect Control, Sao Paulo - Brazil
[4] Univ Sao Paulo, Dept Stat, Sao Paulo - Brazil
[5] Univ Sao Paulo, Inst Trop Med, Sao Paulo - Brazil
[6] Univ Sao Paulo, Dept Infect Dis, Sao Paulo - Brazil
[7] Univ Sao Paulo, LIM54, Sao Paulo - Brazil
Total Affiliations: 7
Document type: Journal article
Source: Journal of Hospital Infection; v. 100, n. 3, p. E163-E168, NOV 2018.
Web of Science Citations: 1
Abstract

Background: There have been few studies exploring implementation strategies to central line-associated bloodstream infections (CLABSIs) in low- or middle-income countries. Aim: To implement tailored interventions to reduce CLABSI rates in adult intensive care units. Methods: The implementation strategy of the State Health Department was performed in Sao Paulo State, Brazil, over two cycles. Cycle 1 (56 hospitals) was exploratory and cycle 2 (77 hospitals) was designed to confirm the hypothesis generated by the first cycle, with three phases each (pre-intervention, intervention, post-intervention). Cycles included: evaluation of healthcare workers' knowledge, observation of practices, and CLABSI rates monthly report. In cycle 1, a log-normal mixed model was used to select variables significantly associated with the reduction of CLABSI. In cycle 2, CLABSI rates were evaluated. Findings: Healthcare workers' practices improved after intervention. In cycle 1, reduction of CLABSI rates was more pronounced in hospitals with initial CLABSI rates >7.4 per 1000 catheter-days (P < 0.001) and those that introduced the use of peripherally inserted central catheters (P= 0.01). For hospitals with high CLABSI initial rates, simulation demonstrated that the rates were expected to decrease by 36% (95% CI: 9-63), no matter the type of intervention. In cycle 2, there was an overall decrease in CLABSI rates during the intervention period; whereas the mean rate fell further post-intervention, rates at the 90th percentile increased. Conclusion: The implementation strategy may have had an effect on infection rates independently of the specific interventions implemented; however, the sustainability of reduction in the post-intervention period remains a challenge. (C) 2018 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved. (AU)

FAPESP's process: 12/11294-2 - Evaluation of the impact of intervention measures in intensive care units in the State of São Paulo
Grantee:Anna Sara Shafferman Levin
Support Opportunities: Regular Research Grants