A Hospital-wide Quality-Improvement Collaborative to Reduce Catheter-Associated Bloodstream Infections

摘要: BACKGROUND: Catheter-associated bloodstream infections (CA BSIs) are associated with increased hospital length of stay, total costs, and mortality. Quality-improvement collaboratives (QICs) frequently used to improve health care quality. Our PICU was previously involved in a successful national QIC reduce the incidence CA BSI critically ill children. OBJECTIVE: We hypothesized that formation hospital-wide would throughout our institution. METHODS: retrospectively reviewed from March 2006 2010. The collaborative approach included implementation central-line insertion maintenance bundles emphasized full sterile barrier precautions chlorhexidine skin preparation during line insertion, daily discussion catheter necessity, meticulous site tubing care. units were 3 critical units, oncology unit, bone marrow transplant wards. Each individual unit responsible for collecting unit-specific data performing event-cause analysis within 48 hours identifying BSI. These results shared other monthly meetings. Compliance monitored reported each monthly. RESULTS: CA-BSI rate decreased baseline 3.0 CONCLUSIONS: resulted significant reduction at children9s hospital. A model based on improvement science methodology is both feasible effective reducing