An intervention to decrease catheter-related bloodstream infections in the ICU. Export

@article{citeulike:1562235, abstract = {BACKGROUND: Catheter-related bloodstream infections occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. METHODS: We conducted a collaborative cohort study predominantly in ICUs in Michigan. An evidence-based intervention was used to reduce the incidence of catheter-related bloodstream infections. Multilevel Poisson regression modeling was used to compare infection rates before, during, and up to 18 months after implementation of the study intervention. Rates of infection per 1000 catheter-days were measured at 3-month intervals, according to the guidelines of the National Nosocomial Infections Surveillance System. RESULTS: A total of 108 ICUs agreed to participate in the study, and 103 reported data. The analysis included 1981 ICU-months of data and 375,757 catheter-days. The median rate of catheter-related bloodstream infection per 1000 catheter-days decreased from 2.7 infections at baseline to 0 at 3 months after implementation of the study intervention (P< or =0.002), and the mean rate per 1000 catheter-days decreased from 7.7 at baseline to 1.4 at 16 to 18 months of follow-up (P<0.002). The regression model showed a significant decrease in infection rates from baseline, with incidence-rate ratios continuously decreasing from 0.62 (95\% confidence interval [CI], 0.47 to 0.81) at 0 to 3 months after implementation of the intervention to 0.34 (95\% CI, 0.23 to 0.50) at 16 to 18 months. CONCLUSIONS: An evidence-based intervention resulted in a large and sustained reduction (up to 66\%) in rates of catheter-related bloodstream infection that was maintained throughout the 18-month study period.}, address = {School of Medicine, Johns Hopkins University, Baltimore, USA}, author = {Pronovost, P. and Needham, D. and Berenholtz, S. and Sinopoli, D. and Chu, H. and Cosgrove, S. and Sexton, B. and Hyzy, R. and Welsh, R. and Roth, G. and Bander, J. and Kepros, J. and Goeschel, C.}, citeulike-article-id = {1562235}, citeulike-linkout-0 = {http://dx.doi.org/10.1056/NEJMoa061115}, citeulike-linkout-1 = {http://content.nejm.org/cgi/content/abstract/355/26/2725}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/17192537}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=17192537}, day = {28}, doi = {10.1056/NEJMoa061115}, issn = {1533-4406}, journal = {N Engl J Med}, keywords = {crbsi, prevention}, month = {December}, number = {26}, pages = {2725--2732}, posted-at = {2008-11-07 15:46:37}, priority = {2}, title = {An intervention to decrease catheter-related bloodstream infections in the ICU.}, url = {http://dx.doi.org/10.1056/NEJMoa061115}, volume = {355}, year = {2006} }

TY - JOUR ID - citeulike:1562235 L3 - citeulike-article-id:1562235 N2 - BACKGROUND: Catheter-related bloodstream infections occurring in the intensive care unit (ICU) are common, costly, and potentially lethal. METHODS: We conducted a collaborative cohort study predominantly in ICUs in Michigan. An evidence-based intervention was used to reduce the incidence of catheter-related bloodstream infections. Multilevel Poisson regression modeling was used to compare infection rates before, during, and up to 18 months after implementation of the study intervention. Rates of infection per 1000 catheter-days were measured at 3-month intervals, according to the guidelines of the National Nosocomial Infections Surveillance System. RESULTS: A total of 108 ICUs agreed to participate in the study, and 103 reported data. The analysis included 1981 ICU-months of data and 375,757 catheter-days. The median rate of catheter-related bloodstream infection per 1000 catheter-days decreased from 2.7 infections at baseline to 0 at 3 months after implementation of the study intervention (P< or =0.002), and the mean rate per 1000 catheter-days decreased from 7.7 at baseline to 1.4 at 16 to 18 months of follow-up (P<0.002). The regression model showed a significant decrease in infection rates from baseline, with incidence-rate ratios continuously decreasing from 0.62 (95% confidence interval [CI], 0.47 to 0.81) at 0 to 3 months after implementation of the intervention to 0.34 (95% CI, 0.23 to 0.50) at 16 to 18 months. CONCLUSIONS: An evidence-based intervention resulted in a large and sustained reduction (up to 66%) in rates of catheter-related bloodstream infection that was maintained throughout the 18-month study period. IS - 26 JF - N Engl J Med SN - 1533-4406 AD - School of Medicine, Johns Hopkins University, Baltimore, USA EP - 2732 TI - An intervention to decrease catheter-related bloodstream infections in the ICU. VL - 355 SP - 2725 KW - crbsi KW - prevention AU - Pronovost, P AU - Needham, D AU - Berenholtz, S AU - Sinopoli, D AU - Chu, H AU - Cosgrove, S AU - Sexton, B AU - Hyzy, R AU - Welsh, R AU - Roth, G AU - Bander, J AU - Kepros, J AU - Goeschel, C PY - 2006/12/28/ UR - http://dx.doi.org/10.1056/NEJMoa061115 ER -