Using the agile implementation model to reduce central line-associated bloodstream infections.

American Journal of Infection Control(2019)

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摘要
Background: Central line-associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI. Methods: We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017. Results: The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable. Conclusions: Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility. (C) 2018 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc.. All rights reserved.
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关键词
Quality improvement,Implementation science,Central line–associated bloodstream infections
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