4.2 Review

Review of Strategies to Reduce Central Line-Associated Bloodstream Infection (CLABSI) and Catheter-Associated Urinary Tract Infection (CAUTI) in Adult ICUs

Journal

JOURNAL OF HOSPITAL MEDICINE
Volume 13, Issue 2, Pages 105-116

Publisher

FRONTLINE MEDICAL COMMUNICATIONS
DOI: 10.12788/jhm.2856

Keywords

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Funding

  1. Agency for Healthcare Research and Quality (AHRQ) [HHSP233201500016I/HHSP23337002T]
  2. AHRQ [2R01HS018334-04]
  3. NIH-LRP program
  4. VA National Center for Patient Safety
  5. Health Research and Educational Trust
  6. American Hospital Association
  7. Centers for Disease Control and Prevention
  8. VA Ann Arbor Patient Safety Center of Inquiry

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Central line-associated bloodstream infection (CLABSI) and catheter-associated urinary tract infection (CAUTI) are costly and morbid. Despite evidence-based guidelines, Some intensive care units (ICUs) continue to have elevated infection rates. In October 2015, we performed a systematic search of the peer-reviewed literature within the PubMed and Cochrane databases for interventions to reduce CLABSI and/or CAUTI in adult ICUs and synthesized findings using a narrative review process. The interventions were categorized using a conceptual model, with stages applicable to both CAUTI and CLABSI prevention: (stage 0) avoid catheter if possible, (stage 1) ensure aseptic placement, (stage 2) maintain awareness and proper care of catheters in place, and (stage 3) promptly remove unnecessary catheters. We also looked for effective components that the 5 most successful (by reduction in infection rates) studies of each infection shared. Interventions that addressed multiple stages within the conceptual model were common in these successful studies. Assuring compliance with infection prevention efforts via auditing and timely feedback were also common. Hospitalists with patient safety interests may find this review informative for formulating quality improvement interventions to reduce these infections. Journal of Hospital Medicine 2018; 13: 105-116. Published online first November 8, 2017. (C) 2018 Society of Hospital Medicine

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