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Title: Prevention of central line-associated bloodstream infections through quality improvement interventions: a systematic review and meta-analysis
Authors: Blot, Koen
BERGS, Jochen 
Vogelaers, Dirk
Blot, Stijn
VANDIJCK, Dominique 
Issue Date: 2014
Source: CLINICAL INFECTIOUS DISEASES, 59 (1), p. 96-105
Abstract: This systematic review and meta-analysis examines the impact of quality improvement interventions on central line–associated bloodstream infections in adult intensive care units. Studies were identified through Medline and manual searches (1995–June 2012). Random-effects meta-analysis obtained pooled odds ratios (ORs) and 95% confidence intervals (CIs). Meta-regression assessed the impact of bundle/checklist interventions and high baseline rates on intervention effect. Forty-one before–after studies identified an infection rate decrease (OR, 0.39 [95% CI, .33–.46]; P < .001). This effect was more pronounced for trials implementing a bundle or checklist approach (P = .03). Furthermore, meta-analysis of 6 interrupted time series studies revealed an infection rate reduction 3 months postintervention (OR, 0.30 [95% CI, .10–.88]; P = .03). There was no difference in infection rates between studies with low or high baseline rates (P = .18). These results suggest that quality improvement interventions contribute to the prevention of central line–associated bloodstream infections. Implementation of care bundles and checklists appears to yield stronger risk reductions.
Keywords: central line–associated bloodstream infection; catheter-related bloodstream infection; quality improvement intervention; meta-analysis
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ISSN: 1058-4838
e-ISSN: 1537-6591
DOI: 10.1093/cid/ciu239
ISI #: 000339665000019
Rights: © The Author 2014. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail:
Category: A1
Type: Journal Contribution
Validations: ecoom 2015
Appears in Collections:Research publications

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