ArticleBMJ (Clinical research ed.)2010
Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study.
Article in BMJ (Clinical research ed.), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 124 papers, 3 of them syntheses that pooled it.
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The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
124 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2014Pooled it
- epic3: national evidence-based guidelines for preventing healthcare-associated infections in NHS hospitals in England.The Journal of hospital infection · 2014Guideline
- Can we make postoperative patient handovers safer? A systematic review of the literature.Anesthesia and analgesia · 2012Pooled it
- Alert-Triggered Patient Education Versus Nurse Feedback for Nonadministered Venous Thromboembolism Prophylaxis Doses: A Cluster-Randomized Controlled Trial.Journal of the American Heart Association · 2022Trial
- Impediments to and impact of checklists on performance of emergency interventions in primary care: anScandinavian journal of primary health care · 2021Trial
- Small volume plasma exchange for Guillain-Barré syndrome in resource-limited settings: a phase II safety and feasibility study.BMJ open · 2018Trial
- Trial
- Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce central venous catheter-related bloodstream infections.Intensive care medicine · 2018Trial
- Trial
- A multi-level system quality improvement intervention to reduce racial disparities in hypertension care and control: study protocol.Implementation science : IS · 2013Trial
- Effect of daily chlorhexidine bathing on hospital-acquired infection.The New England journal of medicine · 2013Trial
- Reimagining the Intensive Care Unit as a Complex Adaptive System: A Systems Thinking Perspective.Cureus · 2026Review
- Engineering anti-thrombogenic and anti-infective catheters through a stepwise metal-catechol-(amine) surface engineering strategy.Bioactive materials · 2024Article
- Challenges and success stories of the implementation of infection control and antimicrobial stewardship strategies: proceedings of the 5th Global Ministerial Summit on Patient Safety, 2023.Antimicrobial resistance and infection control · 2024Article
- Zwitterionic polymers-armored amyloid-like protein surface combats thrombosis and biofouling.Bioactive materials · 2024Article
- Bioinspired Zwitterionic Block Polymer-Armored Nitric Oxide-Generating Coating Combats Thrombosis and Biofouling.Research (Washington, D.C.) · 2024Article
- An analysis of central venous catheter-related bloodstream infections in patients treated in a Swedish Covid-19 intensive care unit.SAGE open medicine · 2024Article
- Significant Reduction in External Ventricular Drain-Related Infections After Introducing a Novel Bundle Protocol: A Before and After Trial.Journal of Korean medical science · 2023Article
- Article
- Evaluation of staff satisfaction after the implementation of a daily goals sheet in the routine work of an oral outpatient department and its influence on work efficiency.BMC health services research · 2022Article
64 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
16 authors.
Funding
Abstract
objectivesTo evaluate the extent to which intensive care units participating in the initial Keystone ICU project sustained reductions in rates of catheter related bloodstream infections. Design Collaborative cohort study to implement and evaluate interventions to improve patients' safety.
settingIntensive care units predominantly in Michigan, USA.
interventionConceptual model aimed at improving clinicians' use of five evidence based recommendations to reduce rates of catheter related bloodstream infections rates, with measurement and feedback of infection rates. During the sustainability period, intensive care unit teams were instructed to integrate this intervention into staff orientation, collect monthly data from hospital infection control staff, and report infection rates to appropriate stakeholders.
main outcome measuresQuarterly rate of catheter related bloodstream infections per 1000 catheter days during the sustainability period (19-36 months after implementation of the intervention).
resultsNinety (87%) of the original 103 intensive care units participated, reporting 1532 intensive care unit months of data and 300 310 catheter days during the sustainability period. The mean and median rates of catheter related bloodstream infection decreased from 7.7 and 2.7 (interquartile range 0.6-4.8) at baseline to 1.3 and 0 (0-2.4) at 16-18 months and to 1.1 and 0 (0.0-1.2) at 34-36 months post-implementation. Multilevel regression analysis showed that incidence rate ratios decreased from 0.68 (95% confidence interval 0.53 to 0.88) at 0-3 months to 0.38 (0.26 to 0.56) at 16-18 months and 0.34 (0.24-0.48) at 34-36 months post-implementation. During the sustainability period, the mean bloodstream infection rate did not significantly change from the initial 18 month post-implementation period (-1%, 95% confidence interval -9% to 7%).
conclusionsThe reduced rates of catheter related bloodstream infection achieved in the initial 18 month post-implementation period were sustained for an additional 18 months as participating intensive care units integrated the intervention into practice. Broad use of this intervention with achievement of similar results could substantially reduce the morbidity and costs associated with catheter related bloodstream infections.
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