Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis

Blot, Koen, Bergs, Jochen, Vogelaers, Dirk, Blot, Stijn and Vandijck, Dominique (2014) Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis. Clinical Infectious Diseases, 59 1: 96-105. doi:10.1093/cid/ciu239


Author Blot, Koen
Bergs, Jochen
Vogelaers, Dirk
Blot, Stijn
Vandijck, Dominique
Title Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis
Journal name Clinical Infectious Diseases   Check publisher's open access policy
ISSN 1537-6591
1058-4838
Publication date 2014-07-01
Year available 2014
Sub-type Article (original research)
DOI 10.1093/cid/ciu239
Open Access Status DOI
Volume 59
Issue 1
Start page 96
End page 105
Total pages 10
Place of publication Cary, NC, United States
Publisher Oxford University Press
Language eng
Subject 2726 Microbiology (medical)
2725 Infectious Diseases
Abstract This systematic review and meta-analysis examines the impact of quality improvement interventions on central line-associated bloodstream infections in adult intensive care units. Studies were identified through Medline and manual searches (1995-June 2012). Random-effects meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Meta-regression assessed the impact of bundle/checklist interventions and high baseline rates on intervention effect. Forty-one before-after studies identified an infection rate decrease (OR, 0.39 [95% CI,. 33-.46]; P <. 001). This effect was more pronounced for trials implementing a bundle or checklist approach (P =. 03). Furthermore, meta-analysis of 6 interrupted time series studies revealed an infection rate reduction 3 months postintervention (OR, 0.30 [95% CI,. 10-.88]; P =. 03). There was no difference in infection rates between studies with low or high baseline rates (P =. 18). These results suggest that quality improvement interventions contribute to the prevention of central line-associated bloodstream infections. Implementation of care bundles and checklists appears to yield stronger risk reductions.
Formatted abstract
This systematic review and meta-analysis examines the impact of quality improvement interventions on central line–associated bloodstream infections in adult intensive care units. Studies were identified through Medline and manual searches (1995–June 2012). Random-effects meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Meta-regression assessed the impact of bundle/checklist interventions and high baseline rates on intervention effect. Forty-one before–after studies identified an infection rate decrease (OR, 0.39 [95% CI, .33–.46]; P < .001). This effect was more pronounced for trials implementing a bundle or checklist approach (P = .03). Furthermore, meta-analysis of 6 interrupted time series studies revealed an infection rate reduction 3 months postintervention (OR, 0.30 [95% CI, .10–.88]; P = .03). There was no difference in infection rates between studies with low or high baseline rates (P = .18). These results suggest that quality improvement interventions contribute to the prevention of central line–associated bloodstream infections. Implementation of care bundles and checklists appears to yield stronger risk reductions.
Keyword Central line-associated bloodstream infection
Catheter-related bloodstream infection
Quality improvement intervention
Meta-analysis
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2015 Collection
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