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).
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.
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].
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