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The “Best Care Always!” (BCA) campaign, was launched in South Africa to reduce common preventable HAI, including catheter associated bloodstream infection (CLABSI)” Richards et al (2017).

Abstract:

BACKGROUND: Health care associated infection (HAI) remains a major international problem.

AIM: The “Best Care Always!” (BCA) campaign, was launched in South Africa to reduce common preventable HAI, including catheter associated bloodstream infection (CLABSI).

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METHODS: The intervention occurred in 43 Netcare Private Hospitals increasing later to 49 with 958 ICU and 439 high care (HC) beds and 1207 ICU and 493 HC beds, respectively. .Phase 1: April 2010-March 2011: ICU Infection Prevention and Control (IPC) nurse driven change: Commitment from management and doctors and training of IPC nurses. Bundle compliance and infections/1000 central-line days were incorporated as standard IPC measures and captured monthly. PHASE 2: April 2011-March 2012: Breakthrough Collaborative method: Multiple regional learning sessions for nursing leaders, IPC nurses and unit managers. PHASE 3: April 2012-May 2016: Sustained goal setting, benchmarks, ongoing audits.

FINDINGS: 1 119 558 central line days were recorded. Bundle compliance improved significantly from a mean of 73.1% [standard deviation (SD) 11.2; range 40.6-81.7%] in phase 1 to a mean of 90.5% (SD 4.7; range 76.5-97.2%) in the final phase (p=0.0004). The CLABSI rate declined significantly from a mean of 3.55 (SD 0.82; range 2.54-5.78)/1000 central line days in phase 1 to a mean of 0.13 (SD 0.09; range 0-0.33) (p<0.0001).

CONCLUSION: This intervention, the first of its kind in South Africa, through considerable motivation and education, and competition between hospitals resulted in significant decreases in CLABSI.

Reference:

Richards, G.A., Brink, A.J., Messina, A.P., Feldman, C., Swart, K. and van den Bergh, D. (2017) Stepwise introduction of the “Best Care Always” central line associated bloodstream infection prevention bundle in a network of South African hospitals. The Journal of Hospital Infection. May 23rd. [Epub ahead of print].

doi: 10.1016/j.jhin.2017.05.013.

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