Systematic review suggests quality improvement interventions prevent CLABSI
Abstract:
This systematic review and meta-analysis examines the impact of quality improvement interventions on central line-associated bloodstream infections in adult ICUs. Studies were identified through Medline and manual searches (1995-June 2012). Random-effects meta-analysis obtained pooled odds ratios (OR) and 95% confidence intervals (CI). 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 0.33-0.46; p<0.001). This effect was more pronounced for trials implementing a bundle or checklist approach (p=0.03). Furthermore, meta-analysis of six interrupted time series studies revealed an infection rate reduction three months post-intervention (OR 0.30; 95% CI 0.10-0.88; p=0.03). There was no difference in infection rates between studies with low or high baseline rates (p=0.18). 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.
Reference:
Blot, K., Bergs, J., Vogelaers, D., Blot, S. and Vandijck, D. (2014) Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis. Clinical Infectious Diseases. April 9th. (epub ahead of print).