Evidence map›Paper›PMID 36410779›Full record

ArticleBMJ open quality2022

Emergent themes from a quality improvement programme for CLABSI/CAUTI prevention in ICUs amid the COVID-19 pandemic.

Daniel M Krauss, Ayrin Molefe, Louella Hung, Kristen Hayes, Claudia Gorman, Michael Latterner, Susan Henderson, Melissa Miller

Open access · goldAbstract read
In one paragraph

Article in BMJ open quality, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
1.4field-weighted citation impact, top 18% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors at 3 institutions in 1 country.

Daniel M KraussHealthcare Evaluation, NORC, Chicago, Illinois, USA krauss-daniel@norc.org.ORCID 0000-0001-5957-8745
Ayrin MolefeCenter for Health Innovation, American Hospital Association, Chicago, Illinois, USA.ORCID 0000-0003-0426-6378
Louella HungCenter for Health Innovation, American Hospital Association, Chicago, Illinois, USA.
Kristen HayesCenter for Health Innovation, American Hospital Association, Chicago, Illinois, USA.
Claudia GormanHealthcare Strategy, NORC, Chicago, Illinois, USA.ORCID 0000-0001-8610-6655
Michael LatternerHealthcare Strategy, NORC, Chicago, Illinois, USA.
Susan HendersonDivision of Healthcare-Associated Infections, Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, Maryland, USA.ORCID 0000-0001-9666-2620
Melissa MillerDivision of Healthcare-Associated Infections, Center for Quality Improvement and Patient Safety, Agency for Healthcare Research and Quality, Rockville, Maryland, USA.ORCID 0000-0003-4820-8946
American Hospital Association · USNational Opinion Research Center · USAgency for Healthcare Research and Quality · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesHealthcare-associated infection (HAI) prevention has been difficult for healthcare providers to maintain during the COVID-19 pandemic. This study summarises themes for maintaining infection prevention activities learnt from the implementation of a quality improvement (QI) programme during the pandemic.

methodsWe conducted qualitative analysis of participants' semistructured exit interviews, self-assessments on HAI prevention activities, participant-created action plans, chat-box discussions during webinars and informal correspondence.

settingIntensive care units (ICUs) with elevated rates of central line-associated bloodstream infections (CLABSI) and/or catheter-associated urinary tract infections (CAUTI) participating in the Agency for Healthcare Research and Quality Safety Programme for ICUs: Preventing CLABSI and CAUTI.

resultsForty-nine ICU teams who participated in the programme between December 2019 and April 2021 found ways to maintain activities such as daily huddles, multidisciplinary rounds, and central line and indwelling urinary catheter monitoring despite barriers, including staff turnover, a lack of time, staff fatigue and pandemic-related guidelines limiting providers' time around patients. We use four themes to summarise the ICU teams' adaptations that allowed them to sustain infection prevention activities: (1) Units had CLABSI and CAUTI prevention teams, policies and practices established prior to the pandemic; (2) Units were flexible in their implementation of those policies and practices; (3) Units maintained consistent buy-in for and engagement in HAI prevention activities among both leadership and care teams throughout the pandemic and (4) Units looked to learn from other units in their facility and beyond.

conclusionsFuture shocks such as the pandemic must be anticipated, and the healthcare system must be resilient to the resulting disruptions to HAI prevention activities. This study encountered four themes for successful maintenance of infection prevention activities during the current pandemic: the value of a pre-existing infection prevention infrastructure; a flexibility in approach; broad buy-in for maintaining QI programmes and the facilitation of idea-sharing.

Indexed as

Catheter-Related InfectionsCOVID-19Cross InfectionUrinary Tract InfectionsHumansInfection ControlIntensive Care UnitsPandemicsQuality ImprovementCOVID-19Critical careInfection controlPatient safetyQuality improvement

Identifiers

PMID36410779
PMCPMC9679866
OpenAlexW4309654056

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.