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Search results for "Device-related Complications"
- Device-related Complications
- Long-Term Care
Journal Article > Review
The preventable proportion of healthcare-associated infections 2005–2016: systematic review and meta-analysis.
Schreiber PW, Sax H, Wolfensberger A, Clack L, Kuster SP; Swissnoso. Infect Control Hosp Epidemiol. 2018;39:1277-1295.
Health care–associated infections (HAIs) represent a significant source of preventable harm to patients. Targeted interventions have been shown to be effective in decreasing HAIs and events once deemed unavoidable, such as central line–associated bloodstream infections, are now considered preventable. In this systematic review and meta-analysis, investigators sought to determine the proportion of HAIs prevented by infection control efforts across countries of different income levels. From the 144 studies ultimately included in the analysis, they found that implementation of evidence-based interventions was associated with an overall reduction in HAIs and that there was no relationship to the financial status of the country in which the study was conducted. A past PSNet perspective discussed infection prevention and patient safety.
Journal Article > Study
Evaluation of the association between Nursing Home Survey on Patient Safety culture (NHSOPS) measures and catheter-associated urinary tract infections: results of a national collaborative.
Smith SN, Greene MT, Mody L, Banaszak-Holl J, Petersen LD, Meddings J. BMJ Qual Saf. 2018;27:464-473.
Measuring safety culture is a core patient safety activity, but the relationship between safety culture and adverse events remains unclear. This prospective cohort study measured nursing home safety culture using the AHRQ Nursing Home Survey on Patient Safety Culture and also measured rates of catheter-associated urinary tract infections (CAUTIs) as part of a quality improvement collaborative. Although safety culture survey results improved and CAUTIs declined over time, after accounting for other factors such as nursing home size and nonprofit versus for-profit status, there was no association between safety culture score and CAUTI rates. The authors recommend focusing on technical aspects of infection control such as standard protocols for catheter insertion rather than safety culture in order to improve patient safety outcomes. Correspondence published in the same issue points out limitations of a related study on the AHRQ Hospital Survey on Patient Safety Culture.
Journal Article > Study
A national implementation project to prevent catheter-associated urinary tract infection in nursing home residents.
Mody L, Greene MT, Meddings J, et al. JAMA Intern Med. 2017;177:1154-1162.
Catheter-associated urinary tract infections are considered preventable never events. This pre–post implementation project conducted in long-term care facilities employed a multimodal intervention, similar to the Keystone ICU project. This sociotechnical approach included checklists, care team education, leadership engagement, communication interventions, and patient and family engagement. The project was conducted over a 2-year period across 48 states. In adjusted analyses, this effort led to a significant decrease in catheter-associated urinary tract infections, despite no change in catheter utilization, suggesting that needed use of catheters became safer. A related editorial declares this project "a triumph" for AHRQ's Safety Program for Long-term Care.
Journal Article > Study
Comparing catheter-associated urinary tract infection prevention programs between Veterans Affairs nursing homes and non–Veterans Affairs nursing homes.
Mody L, Greene MT, Saint S, et al. Infect Control Hosp Epidemiol. 2017;38:287-293.
The Centers for Medicare and Medicaid Services no longer reimburses hospitals for catheter-associated urinary tract infections (CAUTIs), considered a form of preventable harm to patients. Although research in the hospital setting has shown that preventing CAUTIs is possible, little is known about how health care system integration affects the success of infection prevention initiatives. Researchers queried US Department of Veterans Affairs (VA) nursing homes and non-VA nursing homes participating in the AHRQ Safety Program for Long-Term Care collaborative, hypothesizing that those within the integrated VA system would have a more developed infection prevention infrastructure. Out of 494 nursing homes surveyed, 353 responded. A greater proportion of VA nursing homes reported tracking and sharing of CAUTI data, but more non-VA nursing homes had developed policies around catheter use and insertion. The authors conclude that VA and non-VA nursing homes can share best practices so that they can be broadly applied. A past PSNet interview discussed CAUTI prevention.