miércoles, 10 de junio de 2015

Preventing central line-associated bloodstream infections: a qualitative study of management practices. - PubMed - NCBI

Preventing central line-associated bloodstream infections: a qualitative study of management practices. - PubMed - NCBI

 2015 May;36(5):557-63. doi: 10.1017/ice.2015.27. Epub 2015 Feb 23.

Preventing central line-associated bloodstream infections: a qualitative study of management practices.



To identify factors that may explain hospital-level differences in outcomes of programs to prevent central line-associated bloodstreaminfections.


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.


Eight US hospitals that had participated in the federally funded On the CUSP-Stop BSI initiative.


One hundred ninety-four interviewees including administrative leaders, clinical leaders, professional staff, and frontline physicians and nurses.


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 preventinfections. 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.


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.

[PubMed - in process]

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