BACKGROUND: The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line-associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership. METHODS: Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line-days). Process surveillance results at baseline were compared with intervention period data. RESULTS: During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line-days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line-days; relative risk, 0.46 [95% confidence interval, 0.33-0.63]; P < .001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P < .001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001), that adopted chlorhexidine for antisepsis increased from 7% to 27% (P < .001), and that sought to remove unneeded catheters increased from 37% to 83% (P < .001); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001). CONCLUSIONS: Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years.
BACKGROUND: The International Nosocomial Infection Control Consortium (INICC) was established in 15 developing countries to reduce infection rates in resource-limited hospitals by focusing on education and feedback of outcome surveillance (infection rates) and process surveillance (adherence to infection control measures). We report a time-sequence analysis of the effectiveness of this approach in reducing rates of central line-associated bloodstream infection (CLABSI) and associated deaths in 86 intensive care units with a minimum of 6-month INICC membership. METHODS: Pooled CLABSI rates during the first 3 months (baseline) were compared with rates at 6-month intervals during the first 24 months in 53,719 patients (190,905 central line-days). Process surveillance results at baseline were compared with intervention period data. RESULTS: During the first 6 months, CLABSI incidence decreased by 33% (from 14.5 to 9.7 CLABSIs per 1,000 central line-days). Over the first 24 months there was a cumulative reduction from baseline of 54% (from 16.0 to 7.4 CLABSIs per 1,000 central line-days; relative risk, 0.46 [95% confidence interval, 0.33-0.63]; P < .001). The number of deaths in patients with CLABSI decreased by 58%. During the intervention period, hand hygiene adherence improved from 50% to 60% (P < .001); the percentage of intensive care units that used maximal sterile barriers at insertion increased from 45% to 85% (P < .001), that adopted chlorhexidine for antisepsis increased from 7% to 27% (P < .001), and that sought to remove unneeded catheters increased from 37% to 83% (P < .001); and the duration of central line placement decreased from 4.1 to 3.5 days (P < .001). CONCLUSIONS: Education, performance feedback, and outcome and process surveillance of CLABSI rates significantly improved infection control adherence, reducing the CLABSI incidence by 54% and the number of CLABSI-associated deaths by 58% in INICC hospitals during the first 2 years.
Authors: V D Rosenthal; B Ramachandran; W Villamil-Gómez; A Armas-Ruiz; J A Navoa-Ng; L Matta-Cortés; M Pawar; A Nevzat-Yalcin; M Rodríguez-Ferrer; R D Yıldızdaş; A Menco; R Campuzano; V D Villanueva; L F Rendon-Campo; A Gupta; O Turhan; N Barahona-Guzmán; O O Horoz; P Arrieta; J M Brito; M C V Tolentino; Y Astudillo; N Saini; N Gunay; G Sarmiento-Villa; E Gumus; A Lagares-Guzmán; O Dursun Journal: Infection Date: 2012-02-28 Impact factor: 3.553
Authors: V D Rosenthal; S K Todi; C Álvarez-Moreno; M Pawar; A Karlekar; A A Zeggwagh; Z Mitrev; F E Udwadia; J A Navoa-Ng; M Chakravarthy; R Salomao; S Sahu; A Dilek; S S Kanj; H Guanche-Garcell; L E Cuéllar; G Ersoz; A Nevzat-Yalcin; N Jaggi; E A Medeiros; G Ye; Ö A Akan; T Mapp; A Castañeda-Sabogal; L Matta-Cortés; F Sirmatel; N Olarte; H Torres-Hernández; N Barahona-Guzmán; R Fernández-Hidalgo; W Villamil-Gómez; D Sztokhamer; S Forciniti; R Berba; H Turgut; C Bin; Y Yang; I Pérez-Serrato; C E Lastra; S Singh; D Ozdemir; S Ulusoy Journal: Infection Date: 2012-06-19 Impact factor: 3.553
Authors: H Leblebicioglu; A N Yalcin; V D Rosenthal; I Koksal; F Sirmatel; S Unal; H Turgut; D Ozdemir; G Ersoz; C Uzun; S Ulusoy; S Esen; F Ulger; A Dilek; H Yilmaz; O Turhan; N Gunay; E Gumus; O Dursun; G Yýlmaz; S Kaya; H Ulusoy; M Cengiz; L Yilmaz; G Yildirim; A Topeli; S Sacar; H Sungurtekin; D Uğurcan; M F Geyik; A Şahin; S Erdogan; A Kaya; N Kuyucu; B Arda; F Bacakoglu Journal: Infection Date: 2013-01-26 Impact factor: 3.553
Authors: Hail M Al-Abdely; Areej Dhafer Alshehri; Victor Daniel Rosenthal; Yassir Khidir Mohammed; Weam Banjar; Pablo Wenceslao Orellano; Abdullah Mufareh Assiri; Nahla Moustafa Abedel Kader; Hessa Abdullah Al Enizy; Diaa Abdullah Mohammed; Duaa Khalil Al-Awadi; Analen Fabros Cabato; Maria Wasbourne; Randa Saliya; Rosita Gasmin Aromin; Evangelina Balon Ubalde; Hanan Hanafy Diab; Modhi Abdullah Alkamaly; Nawal Mohammed Alanazi; Ibtesam Yahia Hassan Assiry; Apsia Musa Molano; Celia Flores Baldonado; Mohamed Al-Azhary; Sharifa Al Atawi; Apsia Musa Molano; Fatima Mohammad Al Adwani; Arlu Marie Casuyon Pahilanga; Raslan Nakhla; Fatma Mohammad Al Adwani; Deepa Sasithran Nair; Grace Sindayen; Annalyn Amor Malificio; Najla Jameel Helali; Haya Barjas Al Dossari; Ashraf Kelany; Abdulmajid Ghowaizi Algethami; Leigh Yanne; Avigail Tan; Sheema Babu; Shatha Mohammad Abduljabbar; Syed Zahid Bukhari; Roaa Hasan Basri; Jeyashri Jaji Mushtaq; Hala Rushdi; Abdullah Abdulaziz Turkistani; Jerlie Mae Gonzales Celiz; Mohammed Abdullah Al Raey; Ibrahim Am Al-Zaydani Asiri; Saeed Ali Aldarani; Elizabeth Laungayan Cortez; Nadia Lynette Demaisip; Misbah Rehman Aziz; Ali Omer Abdul Aziz; Batool Al Manea; Eslam Samy; Mervat Al-Dalaton; Mohammed Jkedeb Alaliany Journal: J Infect Prev Date: 2016-10-22
Authors: R S Turpin; C Solem; A Pontes-Arruda; M Sanon; S Mehta; F Xiaoqing Liu; M Botteman Journal: Eur J Clin Nutr Date: 2014-03-26 Impact factor: 4.016