READ-   Description of the purpose

The purpose of the Patel et al., (2019) study is to assess the effect of multimodal intervention in hospitals with higher incidents of central line-associated bloodstream infections (CLABSI).

Explanation of research design

The research design of this study looks at the before and after observational assessment of a prospective, national, clustered, nonrandomized initiative of 3 cohorts of hospitals. The National Healthcare Safety Network (NHSN), data was used to determine hospitals with high rates of CLASIs, which was chosen by the Centers for Disease Control and Prevention (CDC) (Patel et al., 2019).

Discussion of sample

A total of 462 hospitals comprised acute care, long-term acute care, and critical access participated over 4 separate cohorts. The cohorts were divided into 4 groups and started and ended on different dates (Patel et al., 2019).

Description of data collection methods

Collecting the data was performed by a state hospital associate person who was given an overview of the study and then asked to complete an in-person assessment at each of the hospitals by using an Infection Control Assessment and Response (ICAR) tool (16) or a Practice Change Assessment (PCA).  The PCA is a shorter type of the ICAR and was developed for States Targeting Reduction in Infections via Engagement (STRIVE) (15) (Patel et al., 2019).

Summary of findings

The monthly CLABSI rates in the pre-implementation ranged between 0 to 71.4 per 1,000 catheter days. The unadjusted CLABSI rate was low throughout the study period and decreased from 0.88 to 0.80 CLABSI per 1,000 catheter days. Device utilization decreased from 24.05 to 22.07 central line days per 100 patient days. Using the multimodal intervention did not reduce rates of CLABSI (Patel et al., 2019).

Strengths of the study 

The strength of this study is the number of hospitals that participated in the study. There were 462 hospitals that took part in this study. Another strength was that this study was well funded national project by the CDC (Patel et al., 2019).

Limitations of the study 

The amount of time that was given for the intervention was too brief. The interventions were not completely evaluated and input and devotion to the study are questionable. Patient descriptions were not measured (Patel et al., 2019).

Recommendations regarding potential application for future practice that are insightful and appropriate.

The recommendations for reducing CLABSI are insightful and appropriate for healthcare professionals placing central lines.  Competency-based training, hand hygiene, personal protective equipment, environmental hygiene, antimicrobial cleaners, strategies, and patient and family interaction are applicable for central line placement and can potentially reduce CLABSI.

Click on the Link to access the article: https://doi.org/10.7326/m18-3533Links to an external site.

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