Working towards zero CLABSI rate and the patient safety profile

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“Central line-associated bloodstream infection (CLABSI) remains one of the most common and deadly hospital acquired infections in the United States. Creating a culture of safety is an important part of healthcare-associated infection improvement efforts; however, few studies have robustly examined the role of safety climate in patient safety outcomes.” Weaver et al (2014).

Reference:

Weaver, S.J., Weeks, K., Pham, J.C. and Pronovost, P.J. (2014) On the CUSP: Stop BSI: Evaluating the relationship between central line-associated bloodstream infection rate and patient safety climate profile. American Journal of Infection Control. 42(10 Suppl), p.S203-8.

Abstract:

BACKGROUND: Central line-associated bloodstream infection (CLABSI) remains one of the most common and deadly hospital acquired infections in the United States. Creating a culture of safety is an important part of healthcare-associated infection improvement efforts; however, few studies have robustly examined the role of safety climate in patient safety outcomes. We applied a pattern-based approach to measuring safety climate to investigate the relationship between intensive care unit (ICU) patient safety climate profiles and CLABSI rates.

METHODS: Secondary analyses of data collected from 237 adult ICUs participating in the On the CUSP: Stop BSI project. Unit-level baseline scores on the Hospital Survey on Patient Safety, a survey designed to assess patient safety climate, and CLABSI rates, were investigated. Three climate profile characteristics were examined: profile elevation, variability, and shape.

RESULTS: Zero-inflated Poisson analyses suggested an association between the relative incidence of CLABSI and safety climate profile shape. K-means cluster analysis revealed 5 climate profile shapes. ICUs with conflicting climates and nonpunitive climates had a significantly higher CLABSI risk compared with ICUs with generative leadership climates.

CONCLUSIONS: Relative CLABSI risk was related to safety climate profile shape. None of the climate profile shapes was related to the odds of reporting zero CLABSI. Our findings support using pattern-based methods for examining safety climate rather than examining the relationships between each narrow dimension of safety climate and broader safety outcomes like CLABSI.

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