采用敏捷实施模式降低中心静脉相关血流感染。
Using the agile implementation model to reduce central line-associated bloodstream infections.
机构信息
Indiana Clinical Translational Sciences Institute, Indiana University, Indianapolis, IN; Center for Health Innovation and Implementation Science, Indiana University School of Medicine, Indianapolis, IN; Indiana University Health, Indianapolis, IN.
Indiana University Health, Indianapolis, IN.
出版信息
Am J Infect Control. 2019 Jan;47(1):33-37. doi: 10.1016/j.ajic.2018.07.008. Epub 2018 Sep 7.
BACKGROUND
Central line-associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI.
METHODS
We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017.
RESULTS
The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P = .011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable.
CONCLUSIONS
Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.
背景
中心静脉导管相关血流感染（CLABSI）是最常见的医院获得性感染之一，可导致患者发病率和死亡率上升。实施实践指南和推荐的预防措施包的情况历来不佳，这表明改进实施方法可以进一步降低 CLABSI 率。本文介绍了敏捷实施方法，并详细介绍了如何成功地利用该方法降低 CLABSI。
方法
我们对印第安纳波利斯的 2 家成人三级保健医院的中心静脉导管患者进行了一项观察性研究，研究时间为 2015 年 1 月至 2017 年 6 月。
结果
该干预措施成功地将 CLABSI 率从每千条中心静脉导管日 1.76 例降低至 1.24 例（比率比=0.70；P=0.011）。我们还观察到艰难梭菌和手术部位感染率的降低，而导管相关尿路感染率保持稳定。
结论
我们使用人工智能模型成功地实施了基于证据的实践，降低了我们机构的 CLABSI 发生率。
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