The Implementation of an Evidence-Based Bundle for Bloodstream Infections in Neonatal Intensive Care Units in Germany: A Controlled Intervention Study to Improve Patient Safety. (5th April 2016)

• Record Type: Journal Article
• Authors: Salm, Florian; Schwab, Frank; Geffers, Christine; Gastmeier, Petra; Piening, Brar
• Is Part Of: Infection control and hospital epidemiology. Volume 37:Number 7(2016)
• Page Start: 798
• Page End: 804
• Publication Date: 2016-04-05
• Subjects: Nosocomial infections -- Epidemiology -- Periodicals; Health facilities -- Sanitation -- Periodicals; Hospital buildings -- Sanitation -- Periodicals; Cross Infection -- Periodicals; Epidemiology -- Periodicals; Hospitals -- Periodicals; Infection Control -- Periodicals; 614.44
• DOI: 10.1017/ice.2016.72
• Languages: English
• ISSNs: 0899-823X

Abstract

Abstract : OBJECTIVE: To improve the patient safety of very-low-birthweight infants in neonatal departments in Germany. DESIGN: Multicenter cohort study with a baseline (24 months), an intervention (12 months), and a postinterventional follow-up period (12 months) and time series analysis. STUDY POPULATION: Very-low-birthweight patients from 32 neonatal departments in Germany. METHODS: Neonatal departments showing a standardized infection ratio of bloodstream infection 10% higher than the expected number (standardized infection ratio ≥1.1) were invited to participate in the study. To reduce the occurrence of primary bloodstream infections, evidence-based bundles to improve catheter maintenance routines, insertion practice, and hand-hygiene compliance were implemented in the participating infirmaries. RESULTS: Thirty-four departments participated in the study and 32 reported data. In total, 6, 222 very-low-birthweight infants with 231, 868 patient-days and 1, 405 cases of bloodstream infections were analyzed. In the baseline period the pooled mean bloodstream infection rate was 6.63 (95% CI, 6.17–7.12) per 1, 000 patient-days. The bloodstream infection rate decreased in the intervention period to 5.68 (relative risk, 0.86 [95% CI, 0.76–0.97]) and in the 1-year follow-up period to 5.31 per 1, 000 patient-days (relative risk, 0.80 [95% CI, 0.70–0.92]). The multivariable time series analysis of monthly aggregated data showed a significant change in the slope for the frequency of bloodstream infections from the start to the end of the intervention (change in slope incidence rate ratio, 0.97; P =.001). CONCLUSION: The implementation of an intervention bundle is feasible and can reduce bloodstream infections in neonatal departments. Infect Control Hosp Epidemiol 2016;37:798–804