Literature DB >> 28989500

Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection.

Hail M Al-Abdely1,2, Areej Dhafer Alshehri1, Victor Daniel Rosenthal3, Yassir Khidir Mohammed1,2, Weam Banjar1, Pablo Wenceslao Orellano3,4, Abdullah Mufareh Assiri1, Nahla Moustafa Abedel Kader5, Hessa Abdullah Al Enizy6, Diaa Abdullah Mohammed7, Duaa Khalil Al-Awadi8, Analen Fabros Cabato2, Maria Wasbourne1, Randa Saliya1, Rosita Gasmin Aromin5, Evangelina Balon Ubalde5, Hanan Hanafy Diab5, Modhi Abdullah Alkamaly5, Nawal Mohammed Alanazi5, Ibtesam Yahia Hassan Assiry5, Apsia Musa Molano6, Celia Flores Baldonado5, Mohamed Al-Azhary5,2, Sharifa Al Atawi6, Apsia Musa Molano6, Fatima Mohammad Al Adwani6, Arlu Marie Casuyon Pahilanga6, Raslan Nakhla6, Fatma Mohammad Al Adwani6, Deepa Sasithran Nair7, Grace Sindayen7, Annalyn Amor Malificio7, Najla Jameel Helali7, Haya Barjas Al Dossari7, Ashraf Kelany7, Abdulmajid Ghowaizi Algethami7, Leigh Yanne7, Avigail Tan7, Sheema Babu7, Shatha Mohammad Abduljabbar7, Syed Zahid Bukhari8, Roaa Hasan Basri8, Jeyashri Jaji Mushtaq8, Hala Rushdi8, Abdullah Abdulaziz Turkistani8, Jerlie Mae Gonzales Celiz2, Mohammed Abdullah Al Raey2, Ibrahim Am Al-Zaydani Asiri2, Saeed Ali Aldarani2, Elizabeth Laungayan Cortez2, Nadia Lynette Demaisip2, Misbah Rehman Aziz2, Ali Omer Abdul Aziz2, Batool Al Manea2, Eslam Samy2, Mervat Al-Dalaton2, Mohammed Jkedeb Alaliany2.   

Abstract

OBJECTIVE: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015.
DESIGN: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (1) a bundle of infection prevention practice interventions; (2) education; (3) outcome surveillance; (4) process surveillance; (5) feedback on CLABSI rates and consequences; and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed.
RESULTS: During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28-0.72; P = 0.001).
CONCLUSIONS: Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia.

Entities:  

Keywords:  Hospital infection; bundle; central line-associated bloodstream infection (CLABSI); critical care; developing countries; device-associated infection; healthcare-acquired infection (HCAI); incidence density; resource-limited countries; surveillance

Year:  2016        PMID: 28989500      PMCID: PMC5298378          DOI: 10.1177/1757177416669424

Source DB:  PubMed          Journal:  J Infect Prev        ISSN: 1757-1782


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