American journal of infection control
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Am J Infect Control · Jun 2014
Beyond the intensive care unit bundle: Implementation of a successful hospital-wide initiative to reduce central line-associated bloodstream infections.
A multimodal hospital-wide central line-associated bloodstream infection (CLABSI) risk reduction strategy was implemented over a 20-month period at an Australian center. Reduced CLABSI rates were observed in both intensive care units (ICUs) (incidence rate ratio [IRR], 0.39; P < .001) and non-ICU wards (IRR, 0.54; P < .001). The median time to CLABSI onset was 7.5 days for ICU events and 13 days for non-ICU events. The timing of infection demonstrates the need for more careful attention to postinsertion care and access of central venous catheters.
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Am J Infect Control · Jun 2014
Environment surface sampling in 33 Washington State fire stations for methicillin-resistant and methicillin-susceptible Staphylococcus aureus.
Methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-susceptible S aureus (MSSA) were isolated from environment surfaces sampled from 33 Washington State fire stations. ⋯ The kit system allowed sampling of >2,000 surfaces from fire stations across Washington State. This is the first time an estimate of the level of MRSA-infected fire personnel has been determined from multiple districts within a single state. Further work is needed to determine if these data can be extrapolated to other career-based fire stations across the country.
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Am J Infect Control · Jun 2014
A multitiered strategy of simulation training, kit consolidation, and electronic documentation is associated with a reduction in central line-associated bloodstream infections.
Simulation-based training has been associated with reduced central line-associated bloodstream infection (CLABSI) rates. We measured the combined effect of simulation training, electronic medical records (EMR)-based documentation, and standardized kits on CLABSI rates in our medical (MICU) and surgical (SICU) intensive care units (ICU). ⋯ Combined simulation training, standardized all-inclusive kits, and EMR-guided documentation were associated with greater documented compliance with sterile precautions and reduced CLABSI rate in our MICU. To achieve maximal benefit, refresher training of senior physicians supervising practice at the bedside may be needed.