central line-associated bloodstream infection
central line-associated bloodstream infection
4) McAlearney, A. S., & Hefner, J. L. (2014). Original article: Facilitating central line–associated bloodstream infection prevention: A qualitative study comparing perspectives of infection control professionals and frontline staff. AJIC: American Journal of Infection Control, 42(Supplement), S216–S222. https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic.2014.04.006
ABSTRACT
Background Infection control professionals (ICPs) play a critical role in implementing and managing healthcare-associated infection reduction interventions, whereas frontline staff are responsible for delivering direct and ongoing patient care. The objective of our study was to determine if ICPs and frontline staff have different perspectives about the facilitators and challenges of central line-associated bloodstream infection (CLABSI) prevention program success.
Methods We conducted key informant interviews at 8 hospitals that participated in the Agency for Healthcare Research and Quality CLABSI prevention initiative called “On the CUSP: Stop BSI.” We analyzed interview data from 50 frontline nurses and 26 ICPs to identify common themes related to program facilitators and challenges.
Results We identified 4 facilitators of CLABSI program success: education, leadership, data, and consistency. We also identified 3 common challenges: lack of resources, competing priorities, and physician resistance. However, the perspective of ICPs and frontline nurses differed. Whereas ICPs tended to focus on general descriptions, frontline staff noted program specifics and often discussed concrete examples.
Conclusions Our results suggest that ICPs need to take into account the perspectives of staff nurses when implementing infection control and broader quality improvement initiatives. Further, the deliberate inclusion of frontline staff in the implementation of these programs may be critical to program success.
5) Donskey, C. J., & Deshpande, A. (2016). Effect of chlorhexidine bathing in preventing infections and reducing skin burden and environmental contamination: A review of the literature. American Journal of Infection Control, 44, e17–e21. https://doi-org.lopes.idm.oclc.org/10.1016/j.ajic.2016.02.024
ABSTRACT
Chlorhexidine bathing is effective in reducing levels of pathogens on skin. In this review, we examine the evidence that chlorhexidine bathing can prevent colonization and infection with health care-associated pathogens and reduce dissemination to the environment and the hands of personnel. The importance of education and monitoring of compliance with bathing procedures is emphasized in order to optimize chlorhexidine bathing in clinical practice.
6) Scheck McAlearney, A., Hefner, J., Robbins, J., Harrison, M., & Garman, A. (2015). Preventing Central Line–Associated Bloodstream Infections: A Qualitative Study of Management Practices. Infection Control & Hospital Epidemiology, 36(5), 557-563. doi:10.1017/ice.2015.27
ABSTRACT
OBJECTIVE: To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line–associated bloodstream infections.
DESIGN: Extensive qualitative case study comparing higher- and lower-performing hospitals on the basis of reduction in the rate of central line–associated bloodstream infections. In-depth interviews were transcribed verbatim and analyzed to determine whether emergent themes differentiated higher- from lower-performing hospitals.
SETTING: Eight US hospitals that had participated in the federally funded On the CUSP—Stop BSI initiative.
PARTICIPANTS: One hundred ninety-four interviewees including administrative leaders, clinical leaders, professional staff, and frontline physicians and nurses.
RESULTS: A main theme that differentiated higher- from lower-performing hospitals was a distinctive framing of the goal of “getting to zero” infections. Although all sites reported this goal, at the higher-performing sites the goal was explicitly stated, widely embraced, and aggressively pursued; in contrast, at the lower-performing hospitals the goal was more of an aspiration and not embraced as part of the strategy to prevent infections. Five additional management practices were nearly exclusively present in the higher-performing hospitals: (1) top-level commitment, (2) physician-nurse alignment, (3) systematic education, (4) meaningful use of data, and (5) rewards and recognition. We present these strategies for prevention of healthcare-associated infection as a management “bundle” with corresponding suggestions for implementation.
CONCLUSIONS: Some of the variance associated with CLABSI prevention program outcomes may relate to specific management practices. Adding a management practice bundle may provide critical guidance to physicians, clinical managers, and hospital leaders as they work to prevent healthcare-associated infections. Infect Control Hosp Epidemiol 2015;00(0): 1–7.
