Intervention Review

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Interventions to improve professional adherence to guidelines for prevention of device-related infections

  1. Gerd Flodgren1,*,
  2. Lucieni O Conterno2,
  3. Alain Mayhew3,
  4. Omar Omar4,
  5. Cresio Romeu Pereira5,
  6. Sasha Shepperd1

Editorial Group: Cochrane Effective Practice and Organisation of Care Group

Published Online: 28 MAR 2013

Assessed as up-to-date: 16 JUL 2012

DOI: 10.1002/14651858.CD006559.pub2

How to Cite

Flodgren G, Conterno LO, Mayhew A, Omar O, Pereira CR, Shepperd S. Interventions to improve professional adherence to guidelines for prevention of device-related infections. Cochrane Database of Systematic Reviews 2013, Issue 3. Art. No.: CD006559. DOI: 10.1002/14651858.CD006559.pub2.

Author Information

  1. 1

    University of Oxford, Department of Public Health, Oxford, Oxfordshire, UK

  2. 2

    Marilia Medical School, Department of General Internal Medicine and Clinical Epidemiology Unit, Marilia, São Paulo, Brazil

  3. 3

    Ottawa Hospital Research Institute, The Ottawa Hospital - General Campus, Centre for Practice-Changing Research, Ottawa, Ontario, Canada

  4. 4

    Centre for Statistics in Medicine, Oxford, UK

  5. 5

    Municipal Health Department, Infection Control, Ilhabela, SP, Brazil

*Gerd Flodgren, Department of Public Health, University of Oxford, Rosemary Rue Building, Old Road Campus, Headington, Oxford, Oxfordshire, OX3 7LF, UK. gerd.flodgren@dph.ox.ac.uk.

Publication History

  1. Publication Status: Edited (no change to conclusions)
  2. Published Online: 28 MAR 2013

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References

References to studies included in this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
Abbott 2006 dataset 1 {published data only}
Abbott 2006 dataset 2 {published data only}
Abbott 2006 dataset 3 {published data only}
Abbott 2006 dataset 4 {published data only}
Beathard 2003 {published data only}
Ching 1990 {published data only}
Cocanour 2006 {published data only}
Coopersmith 2002 {published data only}
  • Coopersmith CM, Rebmann TL, Zack JE, Ward MR, Corcoran RM, Schallom ME, et al. Effect of an education program on decreasing catheter-related bloodstream infections in the surgical intensive care unit. Critical Care Medicine 2002;30(1):59-64.
Kaye 2000 {published data only}
  • Kaye J, Ashline V, Erickson D, Zeiler K, Gavigan D, Gannon L, et al. Critical care bug team: a multidisciplinary team approach to reducing ventilator-associated pneumonia. American Journal of Infection Control 2000;28:197-201.
Miller 2010 {published data only}
  • Miller MR, Griswold M, Harris JM, Yenokyan G, Huskins WC,  Moss M, et al. Decreasing PICU catheter-associated bloodstream infections: NACHRI's quality transformation efforts. Pediatrics 2010;125:206-13.
Parra 2010 {published data only}
  • Parra AP, Menárguez MC, Granda MJP, Tomey MJ, Padilla B, Bouza E. A simple educational intervention to decrease incidence of central line–associated bloodstream infection (CLABSI) in intensive care units with low baseline incidence of CLABSI. Infection Control and Hospital Epidemiology 2010;31(9):964-7.
Salahuddin 2004 {published data only}
  • Salahuddin N, Zafar A, Sukhyani L, Rahim S, Noor KH, Hussain K, et al. Reducing ventilator-associated pneumonia rates through a staff eduction programme. The Journal of Hospital Infection 2004;57:223-7.
Sannoh 2010 {published data only}
  • Sannoh S, Clones B, Munoz J, Montecalvo M, Parvez B. A multimodal approach to central venous catheter hub care can decrease catheter-related bloodstream infection. American Journal of Infection Control 2010;38:424-9.
Sona 2009 {published data only}
  • Sona CS, Zack JE, Schallon ME, McSweeney M, McMullen K, Thomas J, et al. The impact of a simple, low-cost oral care protocol on ventilator-associated pneumonia rates in a surgical intensive care unit. Journal of Intensive Care Medicine 2009;24(1):54-62.
Warren 2004 {published data only}
  • Warren DK, Zack JE, Mayfield JL, Chen A, Prentice D, Fraser VJ, et al. The effect of an educational program on the incidence of central venous catheter-associated bloodstream infection in a Medical ICU. Chest 2004;126:1612-18.
Zack 2002 {published data only}
  • Zack JE, Garrison T, Trovillion E, Clinkscale D, Coopersmith CM, Frase VJ, et al. Effect of an educational program aimed at reducing the occurrence of ventilator-associated pneumonia. Critical Care Medicine 2002;30:2407-12.

References to studies excluded from this review

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
Abramczyk 2011 {published data only}
  • Abramczyk ML, Carvalho WB, Medeiros E. Preventing catheter-associated infections in the paediatric intensive care unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital. Brazilian Journal of Infectious Diseases 2011;15(6):573-7.
Apisarnthanarak 2007 {published data only}
  • Apisarnthanarak A, Pinitchai U, Thongphubeth K, Yuekyen C, Warren DK, Zack JE, et al. Effectiveness of an educational program to reduce ventilator-associated pneumonia in a tertiary care center in Thailand: a 4-year study. Clinical Infectious Disease 2007;45(6):704-11.
Apisarnthanarak 2008 {published data only}
  • Apisarnthanarak A, Suwannakin A, Maungboon P, Warren DK, Fraser VJ. Long-term outcome of an intervention to remove unnecessary urinary catheters, with and without a quality improvement team, in a Thai tertiary care center. Infection Control Hospital Epidemiology 2008;29:1094-5.
  • Apisarnthanarak A, Thongphubeth K, Sirinvaravong S, Kitkangvan D, Yuekyen C, Warachan B, et al. Effectiveness of multifaceted hospital wide quality improvement programs featuring an intervention to remove unnecessary urinary catheters at a tertiary care center in Thailand. Infection Control Hospital Epidemiology 2007;28(7):791-8.
Babcock 2004 {published data only}
  • Babcock HM, Zack JE, Garrison T, Trovillion E, Jones M, Fraser VJ, et al. An educational intervention to reduce ventilator-associated pneumonia in an integrated health system: a comparison of effects. Chest 2004;125(6):2224-31.
Barsuk 2009 {published data only}
  • Barsuk JH, Cohen ER, Feiglass J, McGahie WC, Wayne DB. Use of simulation-based education to reduce catheter-related bloodstream infections. Archives of Internal Medicine 2009;169(15):1420-3.
Baxter 2005 {published data only}
  • Baxter AD, Allan J, Bedard J, Malone-Tucker S, Slivar S, Langill M, et al. Adherence to simple and effective measures reduces the incidence of ventilator-associated pneumonia. Canadian Journal of Anaesthesia 2005;52(5):535-41.
Berenholtz 2004a {published data only}
  • Berenholtz SM, Milanovich S, Faircloth A, Prow TD, Earsing K, Lipsett P, et al. Improving care for the ventilated patient. Joint Commission Journal on Quality and Safety 2004;30(4):195-204.
Berenholtz 2004b {published data only}
  • Berenholtz SM, Provonost PJ, Lipsett PA, Hobson D, Earsing K, Farley JE, et al. Eliminating catheter-related bloodstream infections in the intensive care unit. Critical Care Medicine 2004;32(10):2014-20.
Berg 1995 {published data only}
  • Berg DE, Hershow RC, Ramirez CA, Weinstein RA. Control of nosocomial infections in an intensive care unit in Guatemala city. Clinical Infectious Diseases 1995;21:588-93.
Berhe 2006 {published data only}
  • Berhe M, Edmond MB, Bearman G. Measurement and feedback of infection control process measures in the intensive care unit: Impact on compliance. American Journal of Infection Control 2006;34(8):537-9.
Bird 2010 {published data only}
  • Bird D, Zambuto A, O’Donnell C, Silva J, Korn C, Burke R, et al. Adherence to ventilator-associated pneumonia bundle and incidence of ventilator-associated pneumonia in the surgical intensive care unit. Archives of Surgery 2010;145(5):465-70.
Bizarro 2010 {published data only}
  • Bizzarro MJ, Sabo B, Noonan M, Bonfiglio M, Northrup V, Diefenbach K, Central Venous Catheter Initiative Committee. A quality improvement initiative to reduce central line–associated bloodstream infections in a neonatal intensive care unit. Infection Control and Hospital Epidemiology 2010;31(3):241-8.
Björnestam 2000 {published data only}
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Bruminhent 2010 {published data only}
  • Bruminhent J, Keegan M, Lakhani A, Roberts IM, Passalacqua J. Effectiveness of a simple intervention for prevention of catheter-associated urinary tract infections in a community teaching hospital. American Journal of Infection Control 2010;38:689-93.
Brunelle 2003 {published data only}
  • Brunelle D. Impact of a dedicated infusion therapy team on the reduction of catheter-related nosocomial infections. Journal of Intravenous Nursing 2003;26(6):362-6.
Burns 2003 {published data only}
  • Burns SM, Earven S, Fisher C, Lewis R, Merrell P, Schubart JR, et al. Implementation of an institutional program to improve clinical and financial outcomes of mechanically ventilated patients: One-year outcomes and lessons learned. Critical Care Medicine 2003;31:2752-63.
Camp 2009 {published data only}
Casey 2003 {published data only}
  • Casey J, Davies J. A nurse led central line insertion service. EDTNA/ERCA Journal 2003;29(4):203-5.
Castello 2011 {published data only}
  • Castello FV, Maher A, Cable G. Reducing bloodstream infections in pediatric rehabilitation patients receiving parenteral nutrition. Pediatrics 2011;128(5):e1273-8.
Cherry-Bukowiec 2011 {published data only}
  • Cherry-Bukowiec JR, Denchev K, Dickinson S, Chenoweth CE, Zalewski C, Meldrum C, et al. Prevention of catheter-related blood stream infection: Back to basics?. Surgical Infections 2011;12:27-32.
Chrdle 2012 {published data only}
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Christenson 2006 {published data only}
  • Christenson M, Hitt JA, Abbott G, Septimus EJ, Iversen N. Improving patient safety: Resource availability and application for reducing the incidence of healthcare-associated infection. Infection Control and Hospital Epidemiology 2006;27(3):245-51.
Cohen 1991 {published data only}
  • Cohen IL, Bari N, Strosberg MA, Weinberg PF, Wacksman RM, Millstein BH, et al. Reduction of duration and cost of mechanical ventilation in an intensive care unit by use of a ventilatory management team. Critical Care Medicine 1991;19(10):1278-83.
Cohran 1996 {published data only}
  • Cohran J, Larson E, Roach H, Blane C, Pierce P. Effect of intravascular surveillance and education program on rates of nosocomial bloodstream infections. Heart Lung 1996;25:161-4.
Collingnon 2007 {published data only}
  • Collignon PJ, Dreimanis DE, Beckingham DW, Roberts JL, Gardner A. Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 8 years. Medical Journal of Australia 2007;187(10):551-4.
Cools 1987 {published data only}
Coopersmith 2004 {published data only}
  • Coopersmith CM, Zack JE, Ward MR, Sona CS, Schallom ME, Everett SJ, et al. The impact of bedside behavior on catheter-related bacteremia in the intensive care unit. Archives of Surgery 2004;139(2):131-6.
Cornia 2003 {published data only}
  • Cornia PB, Amory JK, Fraser S, Saint S, Lipsky BA. Computer-based order entry decreases duration of indwelling urinary catheterization in hospitalised patients. American Journal of Medicine 2003;114:404-7.
Costello 2008 {published data only}
  • Costello JM, Morrow DF, Graham DA, Potter-Bynoe G, Sandora TJ. Systematic intervention to reduce central line-associated bloodstream infection rats in a pediatrics cardiac intensive care unit. Pediatrics 2008;121(5):915-23.
Crouzet 2007 {published data only}
  • Crouzet J, Bertrand X, Venier AG, Badoz M, Husson C, Talon D. Control of duration of urinary catheterization: impact on catheter-associated urinary tract infection. Journal of Hospital Infection 2007;67(3):253-7.
Cruden 2000 {published data only}
Danchaivijitr 2005 {published data only}
  • Danchaivijitr S, Assanasen S, Apisarnthanarak A, Judaeng T, Pumsuwan V. Effect of an education program on the prevention of ventilator-associated pneumonia: a multicenter study. Journal of Medical Association of Thailand 2005;88(Suppl 10):S36-S41.
Dawson 2011 {published data only}
  • Dawson D, Endacott R. Implementing quality initiatives using a bundled approach. Intensive and Critical Care Nursing 2011;27:117-20.
Dinç 2000 {published data only}
  • Dinç L, Erdil F. The effectiveness of an educational intervention in changing nursing practice and preventing catheter-related infection for patients receiving total parenteral nutrition. International Journal of Nursing Studies 2000;37:371-9.
Dries 2004 {published data only}
  • Dries DJ, McGonigal MD, Malian MS, Bor BJ, Sullivan C. Protocol-driven ventilator weaning reduces use of mechanical ventilation, rates of early reintubation, and ventilator-associated pneumonia. Journal of Trauma 2004;56:943-52.
Duane 2009 {published data only}
  • Duane TM, Brown H, Borchers CT, Wolfe LG, Malhotra AK, Aboutanos MB, et al . A central venous line protocol decreases bloodstream infections and length of stay in a trauma intensive care unit population. The American Surgeon 2009;75(12):1166-70.
Du Bose 2008 {published data only}
  • Du Bose JJ, Inaba K, Shiflett A, Trankiem C, Teixeira PGR, Salim A, et al. Measurable outcomes of quality improvement in the trauma intensive care unit: the impact of a daily quality rounding checklist. Journal of Trauma 2008;64(1):22-9.
East 2005 {published data only}
  • East D, Jacoby K. The effect of a nursing staff education program on compliance with central line care policy in the cardiac intensive care unit. Pediatric Nursing 2005;31(3):182-94.
Eggimann 2000 {published data only}
  • Eggimann P, Harbarth S, Costantin, Touveneau S, Chevrolet J-C, Pittet D. Impact of a prevention strategy targeted at vascular-access care on incidence of infections acquired in intensive care. Lancet 2000;355(9218):1864-8.
Espiau 2011 {published data only}
  • Espiau M, Pujol M, Campins-Marti M, Planes AM, Pena Y, Balcells J, et al. Incidence of central line-associated bloodstream infection in an intensive care unit. Anales de Pediatria 2011;75(3):188-93.
Esteve 2009 {published data only}
  • Esteve F, Pujol M, Ariza J, Gudiol F, Verdaguer R, Cisnal M, et al. Impact of a prevention program for catheter-related blood stream infection in the intensive care unit of a tertiary hospital [Impacto de un programa de prevención de la bacteriemia relacionada con el cateter en una unidad de cuidados intensivos de un hospital terciario]. Enfermedades Infecciosas e Microbilogía Clínica 2009;27(10):561-5.
Fakih 2010 {published data only}
Frankel 2005 {published data only}
  • Frankel HL, Crede WB, Topal JE, Roumanis SA, Devlin MW, Foley AB. Use of corporate Six Sigma performance-improvement strategies to reduce incidence of catheter-related bloodstream infections in surgical ICU. Journal of American College of Surgeons 2005;201(3):349-58.
French 1989 {published data only}
  • French GL, Wong SL, Cheng AFB, Donna S. Repeated prevalence surveys for monitoring effectiveness of hospital infection control. Lancet 1989;8670(2):1021-3.
García-Rodicio 2009 {published data only}
  • García-Rodicio S, Abajo C, Godoy M, Catalá MA. Development and implementation of an audit tool for quality control of parenteral nutrition. Nutrition in Clinical Practice 2009;24(4):500-7.
Gaynes 2001 {published data only}
  • Gaynes R, Richards C, Edwards J, Emori TG, Horan T, Alonso-Echanove J. Feeding back surveillance data to prevent hospital-acquired infection. Emerging Infectious Diseases 2001;7(2):295-8.
Gnass 2004 {published data only}
  • Gnass SA, Barboza L, Bilicich D, Angeloro P, Treyer W, Grenóvero S, et al. Prevention of central venous catheter-related bloodstream infections using non-technologic strategy. Infection Control and Hospital Epidemiology 2004;25(8):675-7.
Goddard 2006 {published data only}
  • Goddard L, Clayton S, Peto TEA, Bowler ICJW. The 'just-in-case venflon': effect of surveillance and feedback on prevalence of peripherally inserted intravascular devices. Journal of Hospital Infection 2006;64(4):401-2.
Goetz 1999 {published data only}
  • Goetz AM, Kedzuf S, Wagener M, Muder RR. Feedback to nursing staff as an intervention to reduce catheter-associated urinary tract infection. American Journal of Infection Control 1999;27(5):402-4.
Gokula 2007 {published data only}
  • Gokula MR, Smith MA, Hickner J. Emergency room staff education and use of a urinary catheter indication sheet improves appropriate use of foley catheters. American Journal of Infection Control 2007;35(9):589-93.
Gowardman 2005 {published data only}
  • Gowardman JR, Kelaher C, Whiting J, Collignon PJ. Impact of a formal removal policy for central venous catheters on duration of catheterisation. Medical Journal of Australia 2005;182(5):249-50.
Gozu 2011 {published data only}
  • Gozu A, Clay C, Younus F. Hospital-wide reduction in central line-associated bloodstream infections: a tale of two small community hospitals. Infection Control and Hospital Epidemiology 2011;32(6):619-22.
Grap 2003 {published data only}
  • Grap MJ, Strickland D, Tormey L, Keane K, Lubin S, Emerson J. Collaborative practice: development, implementation, and evaluation of a weaning protocol for patients receiving mechanical ventilation. American Journal of Critical Care 2003;12(5):454-60.
Guerin 2010 {published data only}
  • Guerin K, Wagner J, Rains K, Bessesen M. Reduction in central line-associated bloodstream infections by implementation of a post insertion care bundle. American Journal of Infection Control 2010;38(6):430-3.
Guner 2011 {published data only}
  • Guner R, Hasanoglu I, Keske S, Tasyaran MA. Educational approach to reduce catheter-related bloodstream infections and catheter-related urinary tract infection rates in intensive care unit. Clinical microbiology and infection. Proceedings of the 21st ECCMID/27th ICC Conference; 2011. Milan, 2011:S775.
Gunther 2009 {published data only}
  • Gunther SG, Schwebel C, Vésin A, Remy J, Dessertaine G, Timsit JF. Interventions to decrease tube, line, and drain removals in intensive care units: the FRATER study. Intensive Care Medicine 2009;35:1772-6.
Gurskis 2009 {published data only}
  • Gurskis V, Asembergiene J, Kevalas R, Miciulevicine, Pavilonis A, Valinteliene R, et al. Reduction of nosocomial infection and mortality attributable to nosocomial infections in pediatric intensive care units in Lithuania. Medicina (kaunas) 2009;45(2):203-13.
Gusarov 2009 {published data only}
  • Gusarov VG. Impact of pneumonia prevention protocol on the results of treatment in patients in the acute period of stroke. Anesteziologiia i reanimantologiia 2009;May-June(3):34-7.
Hansen 2006 {published data only}
  • Hansen BG. Reducing nosocomial urinary tract infections through process improvement. Journal for Healthcare Quality Web Exclusive 2006;28(2):W2-9.
Harnage 2007 {published data only}
  • Harnage SA. Achieving zero catheter related blood stream infections: 15 months success in a community based medical center. Journal of The Association for Vascular Access 2007;12(4):218-24.
Hatler 2006 {published data only}
  • Hatler CW, Mast D, Corderella J, Mitchell G, Howard K, Aragon J, et al. Using evidence and process improvement strategies to enhance healthcare outcomes for the critically ill: a pilot project. American Journal of Critical Care 2006;15(6):549-55.
Helman 2003 {published data only}
  • Helman DL, Sherner JH, Fitzpatrick TM, Callender ME, Shorr AF. Effect of standardized orders and provider education on head-of-bed positioning in mechanically ventilated patients. Critical Care Medicine 2003;31(9):2285-90.
Hendrix 1998 {published data only}
  • Hendrix MS, Fieselmann JF, Bock MJ, Wakefield DS, Helms MC, Bentler SE. Outreach education to improve quality of rural ICU care. American Journal of Respiratory Critical Care Medicine 1998;158:418-23.
Hiemenz 1986 {published data only}
Higuera 2005 {published data only}
  • Higuera F, Rosenthal DV, Duarte P, Ruiz J, Franco G, Safdar N. The effect of process control on the incidence of central venous catheter-associated bloodstream infections and mortality in intensive care units in Mexico. Critical Care Medicine 2005;33(9):2022-7.
Holzmann-Pazgal 2012 {published data only}
  • Holzmann-Pazgal G, Kubanda A, Davis K, Khan AM, Brumley K, Denson SE. Utilizing a line maintenance team to reduce central-line-associated bloodstream infections in a neonatal intensive care unit. Journal of Perinatology 2012;32(4):281-6.
Hong 1990 {published data only}
  • Hong SW, Ching TY, Fung JP, Seto WL. The employment of ward opinion leaders for continuing education in the hospital. Medical Teacher 1991;12(2):209-217.
Horbar 2006 {published data only}
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Huang 2004 {published data only}
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Hwang 2005 {published data only}
  • Hwang JH, Choi CW, Chang YS, Choe YH, Park WS, Shin SM, et al. The efficacy of clinical strategies to reduce nosocomial sepsis in extremely low birth weight infants. Journal of Korean Medical Science 2005;20:177-81.
Jain 2006 {published data only}
  • Jain M, Miller L, Belt D, King D, Berwick DM. Decline in ICU adverse events, nosocomial infections and cost through a quality improvement initiative focusing on teamwork and culture change. Quality on Safety in Health Care 2006;15:235-9.
Jeffreis 2009 {published data only}
  • Jeffries HE, Mason W, Brewer M, Oakes KL, Munoz EI, Gornick W, et al. Prevention of central venous catheter-associated bloodstream infections in paediatric intensive care units: a performance improvement collaborative. Infection Control and Hospital Epidemiology 2009;30(7):645-51.
Jonhson 2009 {published data only}
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Kalra 2011 {published data only}
  • Kalra S, Nelson Y, Dave P, Wadhwa R. Student assessment of teaching effectiveness of "bundle of changes"- A paired, controlled trial. Journal of Anaesthesiology, Clinical Pharmacology 2011;27(4):506-10.
Karada 2000 {published data only}
  • Karada A, Görgülü S. Devising an intravenous fluid therapy protocol and compliance of nurses with the protocol. Journal of Intravenous Nursing 2000;23(4):232-8.
Kauffmann 2011 {published data only}
  • Kauffmann G, Davis A, Schulwolf E, Press V, Stupay K, Arora V. IBCD: Development and testing of a checklist to improve quality of care for hospitalized general medical patients. Journal of Hospital Medicine 2011;6(4):S117-8.
Kaye 2006 {published data only}
  • Kaye KS, Engemann JJ, Fulmer EM, Clark CC, Noga EM. Favorable impact of an infection control network on nosocomial infection rates in community hospitals. Infection Control and Hospital Epidemiology 2006;27(3):228-32.
Kelleghan 1993 {published data only}
  • Kelleghan SI, Salemi C, Padilla S, McCord M, Mermilliod G, Canola T, et al. An effective continuous quality improvement approach to the prevention of ventilator-associated pneumonia. American Journal of Infection Control 1993;21(6):322-30.
Kellie 2012 {published data only}
  • Kellie SP, Scott MJ, Cavallazzi R, Wiemken TL, Goss L, Parker D, et al. Procedural and educational interventions to reduce ventilator-associated pneumonia (VAP) rate and central line-associated blood stream infections (CLABSI). Chest. 2011; Vol. 140, issue 4:350A. [DOI: 10.1378/chest.1081447]
Khatib 1999 {published data only}
Kidd 2007 {published data only}
  • Kidd KM, Sinkowitz-Cochran RL, Giblin TB, Tokars JI, Cardo DM, Solomon SL. Barriers to and facilitators of implementing an intervention to reduce the incidence of catheter-associated bloodstream infections. Infection Control and Hospital Epidemiology 2007;28(1):103-4.
Kilbride 2003 {published data only}
  • Kilbride HW, Powers R, Wirtschafter DD, Sheehan MB, Charsha DS, LaCorte M. Evaluation and development of potentially better practices to prevent neonatal nosocomial bacteraemia. Pediatrics 2003;111(4 Pt 2):e504–18.
Koff 2011 {published data only}
  • Koff MD, Corwin HL, Beach ML, Surgenor SD, Loftus RW. Reduction in ventilator associated pneumonia in a mixed intensive care unit after initiation of a novel hand hygiene program. Journal of Critical Care 2011;26(5):489-95.
Kulvatunyou 2007 {published data only}
  • Kulvatunyou N, Boonbarwornrattanakul A, Soonthornkit Y, Kocharsanee C, Lertsithichai P. Incidence of ventilator-associated pneumonia (VAP) after the institution of an educational program on VAP prevention. Journal of the Medical Association of Thailand 2007;90(1):89-95.
Lai 2003 {published data only}
  • Lai KK, Baker SP, Fontecchio SA. Impact of a program of intensive surveillance and interventions targeting ventilated patients in the reduction of ventilated patients in the reduction of ventilator-associated pneumonia and its cost-effectiveness. Infection Control and Hospital Epidemiology 2003;24(11):859-63.
Lally 1997 {published data only}
  • Lally R, Farber M, Biorn J. Successful use of a quality improvement team to reduce ventilator-associated pneumonia. Critical Care Nurse 1997;17(6):38-46.
Laux 2006 {published data only}
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Lobo 2005 {published data only}
  • Lobo RD, Levin AS, Gomes LMB, Cursino R, Park M, Figueiredo VB, et al. Impact of an educational program and policy changes on decreasing catheter-associated bloodstream infections in a medial intensive care in Brazil. American Journal of Infection Control 2005;33:85-7.
Lobo 2010 {published data only}
  • Lobo RD, Levin AS, Oliveira MS, Gomes LMB, Gobara S, Park M, et al. Evaluation of interventions to reduce catheter-associated bloodstream infection: Continuous tailored education versus one basic lecture. American Journal of Infection Control 2010;38(6):440-8.
Lolom 2009 {published data only}
  • Lolom I, Deblamgy C, Capelle A, Guerinot W, Bouvet E, Barry B, et al. Effect of a long-term quality improvement program on the risk of infection related to peripheral venous catheters [Impact d'un programme prolonge d'amelioration continur de la qualitye sur le risqué infectieux lie aux catheters veineux peripheriques]. Presse Medicale 2009;38(1):34-42.
Lyerla 2010 {published data only}
  • Lyerla F, LeRouge C, Cooke DA, Turpin D, Wilson L. A nursing clinical decision support system and potential predictors of head-of-bed position for patients receiving mechanical ventilation. American Journal of Critical Care 2010;19:39-47.
Maas 1998 {published data only}
  • Maas A, Flament P, Pardou A, Deplan A, Dramaix M, Struelens MJ. Central venous catheter-related bacteraemia in critically ill neonates: risk factors and impact of a prevention programme. Journal of Hospital Infection 1998;40:211-24.
Marelich 2000 {published data only}
  • Marelich GP, Murin S, Battistella F, Inciardi J, Vierra T, Roby M. Protocol weaning of mechanical ventilation in medical and surgical patients by respiratory care practioners and nurses. Chest 2000;118(2):459-67.
Marra 2009 {published data only}
  • Marra AR, Cal RG, Silva CV, Caserta RA, Paes AT, Moura DF Jr. Successful prevention of ventilator-associated pneumonia in an intensive care setting. American Journal of Infection Control 2009;37(8):619-25.
Matocha 2011 {published data only}
  • Matocha D. A process improvement approach to the elimination of central line associated bloodstream infections. Proceedings of the Association for Vascular Access Annual Scientific Meeting; 2011 October 3-6; San Jose, California. http://www.avainfo.org/website/download.asp?id=280432 (accessed 1 July 2012).
Mazi 2011 {published data only}
  • Mazi W, Abdullah D, Gasem G, Helali N, Senok A. Reduction of healthcare-associated infections after implementation of bundle programmes in a tertiary care teaching hospital in Saudi Arabia. Clinical Microbiology and Infection. Proceedings of 21st ECCMID/27th ICC Conference. Milan, 2011:S327-8.
Mckee 2008 {published data only}
  • Mckee C, Berkowitz I, Cosgrove SE, Bradley K, Beers C, Peri TM, et al. Redution of catheter-associated bloodstream infections in paediatric patients: experimentation and reality. Pediatric Critical Care Medicine 2008;9(1):40-6.
Mckinley 2003 {published data only}
  • Mckinley LL, Moriarty HJ, Short TH, Johnson CC. Effect of comparative data feedback on intensive care unit infection rates in a Veterans Adminstration Hospital Network System. American Journal of Infection Control 2003;31(7):397-404.
McLean 2006 {published data only}
  • McLean SE, Jesen LA, Schoeder DG, Gibney NRT, Skjoddt NM. Improving adherence to a mechanical ventilation weaning protocol for critically ill adults: outcomes after an implementation program. American Journal of Critical Care 2006;15(3):299-309.
Meier 1998 {published data only}
  • Meier PA, Fredrickson M, Catney M, Nettleman MD. Impact of a dedicated intravenous therapy team on nosocomial bloodstream infection rates. American Journal of Infection Control 1998;26:388-92.
Miller 2010a {published data only}
  • Miller RS, Norris PR, Jenkins JM, Talbot TR, Starmer JM, Hutchison AS. Systems initiatives reduce healthcare-associated infections: a study of 22,928 device days in a single trauma unit. The Journal of Trauma 2010;68(1):23-31.
Miranda 2007 {published data only}
Misset 2004 {published data only}
  • Misset B, Timsit JF, Dumay MF, Garrouste M, Chalfine A, Flouriot I, et al. A continuous quality-improvement program reduces nosocomial infection rates in the ICU. Intensive Care Medicine 2004;30(3):395-400.
Ngo 2005 {published data only}
  • Ngo A, Murphy S. A theory-based intervention to improve nurses' knowledge, self-efficacy, and skills to reduce PICC occlusion. Journal of Infusion Nursing 2005;28(3):173.
Ong 2011 {published data only}
  • Ong A, Dysert K, Herbert C, Laux L, Granato J, Crawford J, et al. Trends in central line-associated bloodstream infections in a trauma-surgical intensive care unit. Archives of Surgery 2011;146(3):302-7.
Orsi 2005 {published data only}
  • Orsi GB, Raponi M, Franchi C, Rocco M, Mancini C, Venditti M. Surveillance and infection control in an intensive care unit. Infection Control and Hospital Epidemiology 2005;26(3):321-5.
Parras 1994 {published data only}
  • Parras F, Ena J, Bouza E, Guerrero MC, Moreno S, Galvez T, et al. Impact of an educational program for the prevention of colonization of intravascular catheter. Infection Control and Hospital Epidemiology 1994;15(4):239-42.
Penne 2002 {published data only}
  • Penne K. Using evidence in central catheter care. Seminars in Oncology Nursing 2002;18(1):66-70.
Peredo 2010 {published data only}
  • Peredo R, Sabatier C, Villagrá A, González J, Hernández C, Pérez F, et al. Reduction in catheter-related bloodstream infections in critically ill patients through a multiple system intervention. European Journal of Clinical Microbiology and Infectious Diseases 2010;29(9):1173-7.
Pérez-González 2007 {published data only}
  • Pérez-González LF, Ruiz-González JM, Noyola DE. Nosocomial bacteremia in children: a 15-year experience at a general hospital in Mexico. Infection Control and Hospital Epidemiology 2007;28(4):418-22.
Pethyoung 2005 {published data only}
  • Pethoung W, Picheansathian W, Boonchuang P, Apisarnthanarak A, Danchaivijitr S. Effectiveness of education and quality control work group focusing on nursing practices for prevention of ventilator-associated pneumonia. Journal of the Medical Association of Thailand 2005;88(Suppl 10):S110-114.
Pronovost 2008 {published data only}
  • Pronovost P. Intervention to decrease catheter-related bloodstream infections in the ICU: the Keystone Intensive Care Unit Project. American Journal of Infection Control 2008;36(10):S171.e1-5.
Pronovost 2010 {published data only}
  • Pronovost PJ, Goeschel CA, Colantuoni E, Watson S, Lubomski LH, Berenholtz SM, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study. BMJ 2010;c:309:1-6.
  • Provonost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine 2006;355(26):2725-32.
Puntis 1990 {published data only}
  • Putins JWL, Holden CE, Smallman S, Finkel Y, George RH, Booth IW. Staff training: a key factor in reducing intravascular catheter sepsis. Archives of Disease in Childhood 1990;65(3):335-7.
Reilly 2006 {published data only}
  • Reilly L, Sullivan P, Ninni S, Fochesto D, Williams K, Fetherman B. Reducing foley catheter device days in an intensive care unit. AACN Advance Critical Care 2006;17(3):272-83.
Rello 2011 {published data only}
  • Rello J, Chastre J, Cornaglia G, Masterton R. A European care bundle for management of ventilator-associated pneumonia. Journal of Critical Care 2011;26(1):3-10.
Rosenthal 2003 {published data only}
  • Rosenthal VD, Guzman S, Pezzotto S, Christopher JC. Effect of an infection control program using education and performance feedback on rates of intravascular device-associated bloodstream infections in intensive care units in Argentina. American Journal of Infection Control 2003;31:405-9.
Rosenthal 2004 {published data only}
  • Rosenthal DV, Guzman S, Safdar N. Effect of education and performance feedback on rates of catheter-associated urinary tract infection in intensive care units in Argentina. Infection Control and Hospital Epidemiology 2004;25:47-50.
Rosenthal 2006a {published data only}
  • Rosenthal DV, Guzman, Crnich C. Impact of an infection control program on rates of ventilator-associated pneumonia in intensive care units in 2 Argentinean hospitals. American Journal of Infection Control 2006;34:58-63.
Rosenthal 2008 {published data only}
  • Rosenthal VD. Device-associated nosocomial infections in limited-resources countries: findings of the International Nosocomial Infection Control Consortium (INICC). American Journal of Infection Control 2008;36(10):S171.e7-S171.e12.
Saint 2005 {published data only}
  • Saint S, Kaufman SR, Thompson M, Rogers MAM, Chenoweth CE. A reminder reduces urinary catheterization in hospitalised patients. Journal on Quality and Patient Safety 2005;31(8):455-62.
Sansivero 2011 {published data only}
  • Sansivero G, Galloway M. Registered professional nurses placing central vascular access catheters via the internal jugular vein at the bedside: One year evaluation of a pilot program. Journal of Vascular Access 2011;12(1):84-5.
Santana 2008 {published data only}
  • Santana SL, Furtado GHC, Wey SB, Medeiros EAS. Impact of an education program on the incidence of central line-associated bloodstream infection in 2 medical-surgical intensive care units in Brazil. Infection Control and Hospital Epidemiology 2008;29(12):1171-3.
Scales 2009 {published data only}
  • Scales DC, Dainty K, Hales B, Pinto R, Fowler RA, Adhikari NKJ. An innovative telemedicine knowledge translation program to improve quality of care in intensive care units: protocol for a cluster randomised pragmatic trial. Implementation Science 2009;4(5):1-9. [DOI: 10.1186/1748-5908-4-5]
Scales 2011a {published data only}
  • Scales K. Reducing infection associated with central venous access devices. Nursing Standard 2011;25(36):49-56.
Seguin 2010 {published data only}
  • Seguin P, Laviolle B, Isslame S, Coué A, Mallédant Y. Effectiveness of simple daily sensitization of physicians to the duration of central venous and urinary tract catheterization. Intensive Care Medicine 2010;36(7):1202-6.
Seto 1991 {published data only}
Shapey 2009 {published data only}
  • Shapey IM, Foster MA, Whitehouse T, Jumaa P, Bion JF. Central venous catheter-related bloodstream infections: improving post-insertion catheter care. Hospital Infection Control 2009;71(2):117-22.
Sherertz 2000 {published data only}
  • Sherertz RJ, Ely EW, Westbrook DM, Gledhill KS, Streed SA, Kiger B, et al. Education of physicians-in-training can decrease the risk for vascular catheter infection. Annals of Internal Medicine 2000;132:641-8.
Smith 2011 {published data only}
  • Smith L, Elamin E. Implementation of evidence-based guidelines in reducing catheter related bloodstream infections. Chest. Proceedings of the CHEST Conference. Honolulu, 2011.
Soifer 1998 {published data only}
Sutton 2005 {published data only}
  • Sutton CD, Garcea G, Pollard C, Berry DP, Dennison AR. The introduction of a nutrition clinical nurse specialist results in a reduction in the rate of catheter sepsis. Clinical Nutrition 2005;24:220-3.
Sydnor 2011 {published data only}
  • Sydnor ERM, Perl TM. Hospital epidemiology and infection control in acute-care settings. Clinical Microbiology Reviews 2011; Vol. 24, issue 1:141-73.
Timsit 2011 {published data only}
  • Timsit J-F, Minet C, Lugosi M, Calvino-Gunther S, Ara-Somohano C, Bonadona A, et al. Prevention of catheter-related infections in ICU. Journal des Anti-Infectieux 2011;13(3):161-9.
Tolentino DelosReyes 2007 {published data only}
  • Tolentino Delos Reyes AF, Ruppert SD, Shiao SY. Evidence-based practice: use of the ventilator bundle to prevent ventilator-associated pneumonia. American Journal of Critical Care 2007;16(1):20-27.
Topal 2005 {published data only}
  • Topal J, Conklin S, Camp K, Morris V, Balcezak T, Hebert P. Prevention of nosocomial catheter-associated urinary tract infections through computerized feedback to physicians and a nurse-directed protocol. American Journal of Medical Quality 2005;20(3):121-6.
Troeng 2011 {published data only}
  • Troeng M. Evaluation of an educational programme in management and care of central venous access devices. Journal of Vascular Access 2011;12(1):90.
Tsuchida 2007 {published data only}
  • Tsuchida T, Makimot K, Toki M, Sakai K, Onaka E, Otono Y. The effectiveness of a nurse-initiated intervention to reduce catheter-associated bloodstream infections in an urban acute hospital: An intervention study with before and after comparison. International Journal of Nursing Studies 2007;44:1324-33.
Urrea Ayala 2009 {published data only}
  • Ayala MU, Quesada LR. Catheter-associated blood stream infections: Implementation of a new consensus protocol [La bacteriemia asociada al cateter venoso central: implementación de un nuevo protocolo de consenso]. Anales de Pediatria 2009;71(1):20-4.
Verdier 2006 {published data only}
  • Verdier R, Parer S, Jean-Pierre H, Dujols P, Picot MC. Impact of an infection control program in an intensive care unit in France. Infection Control and Hospital Epidemiology 2006;27(1):60-6.
Wall 2005 {published data only}
  • Wall Rj, Ely EW, Elasy TA, Dittus RS, Foss J, Wilkerson KS, et al. Using real time process measurements to reduce catheter related bloodstream infections in the intensive care unit. Quality and Safety in Health care 2005;14:295-302.
Warren 2003 {published data only}
  • Warren DK, Zack JE, Cox MJ, Cohen MM, Fraser VJ. An educational intervention to prevent catheter-associated bloodstream infections in a non teaching, community medical center. Critcal Care Medicine 2003;31(7):1959-63.
Warren 2006 {published data only}
  • Warren DK, Cosgrove SE, Diekema DJ, Zuccotti G, Climo MW, Bolon MK, et al. A multicenter intervention to prevent catheter-associated bloodstream infections. Infection Control and Hospital Epidemiology 2006;27:662-9.
Weireter 2009 {published data only}
  • Weireter LJ, Collins JN, Britt RC, Reed SF, Novosel TJ, Britt LD. Impact of a monitored program of care on incidence of ventilator-associated pneumonia: results of a long term performance-improvement project. Journal of American College of Surgeons 2009;208:700-5.
Westwell 2008 {published data only}
Williams 2008 {published data only}
  • Williams Z, Rodney C, Kelly E. A single device to increase rate of compliance in maintaining 30-degree head-of-bed elevation in ventilated patients. Critical Care Medicine 2008;36(4):115-7.
Wirtschafter 2010 {published data only}
  • Wirtschafter DD, Pettit J, Kurtin P, Dalsey M, Chance K, Morrow HW. A statewide quality improvement collaborative to reduce neonatal central line-associated blood stream infections. Journal of Perinatology 2010;30:170-81.
Worrall 2010 {published data only}
  • Worrall CL, Anger PB, Simpson KN, Leon SM. Impact of a hospital-acquired/ventilator-associated/healthcare-associated pneumonia practice guideline on outcomes in surgical trauma patients. Journal of Trauma 2010;68:382-6.
Xiao 2007 {published data only}
  • Xiao Y, Seagull J, Bochicchio GV, Guzzo JL, Dutton RP, Sisley A, et al. Video-based training increases sterile-technique compliance during central venous catheter insertion. Critical Care Medicine 2007;35:1302-6.
Yoo 2001 {published data only}
  • Yoo S, Ha M, Choi D, Hynjoo P. Effectiveness of surveillance of central catheter-related bloodstream infection in an ICU in Korea. Infection Control and Hospital Epidemiology 2001;22(7):433-6.
Youngquist 2007 {published data only}
  • Youngquist P, Carroll M, Farber M, Macy D, Madrid P, Ronning J, et al. Implementing a ventilator bundle in a community hospital. Journal of Quality and Patient Safety 2007;33(4):219-25.
Zaydfudin 2009 {published data only}
  • Zaydfundim V, Dosset LA, Starmer JM, Arbogast PG, Feurer ID, Ray AW. Implementation of a real-time compliance dashboard to help reduce SICU ventilator-Associated pneumonia with the ventilator bundle. Archives of Surgery 2009;144:656-62.
Zingg 2009 {published data only}
  • Zingg W, Imhof A, Maggiorini M, Stocker R, Keller E, Ruef C. Impact of a prevention strategy targeting hand hygiene and catheter care on the incidence of catheter-related bloodstream infections. Critical Care Medicine 2009;37(7):2167-73.
Zuschneid 2003 {published data only}
  • Zuschneid I, Schwab F, Geffers C, Ruden H, Gastmeier P. Reducing central venous catheter-associated primary bloodstream infections in intensive care units is possible: data from the German nosocomial infection surveillance system. Infection Control and Hospital Epidemiology 2003;24:501-5.

References to studies awaiting assessment

  1. References to studies included in this review
  2. References to studies excluded from this review
  3. References to studies awaiting assessment
  4. Additional references
Chen 2011 {published data only}
  • Chen YZ, Yan CY. Hematology-oncology port-A: improving nursing care quality. Hu Li Tsa Chih - Journal of Nursing 2011;58(3 Suppl):64-72.
Danchaivijitr 1992 {published data only}
  • Danchaivijitr S, Chokloikaew S, Tangtrakool T, Waitayapiches S. Does indication sheet reduce unnecessary urethral catheterization?. Journal of the Medical Association of Thailand 1992;75(Suppl 2):1-5.
Eid 2011 {published data only}
  • Eid R, Domingues F, Barretto JKS, Marra AR, Silva CV, Paes AT, et al. Successful prevention of tracheostomy associated pneumonia in step-down units. American Journal of Infection Control 2011;39(6):500-5.
Kaplan 2011 {published data only}
  • Kaplan HC, Lannon C, Walsh MC, Donovan EF, Ohio Perinatal Quality Collaborative. Ohio statewide quality-improvement collaborative to reduce late-onset sepsis in preterm infants. Pediatrics 2011;127(3):427-35.
Khouli 2011 {published data only}
  • Khouli H, Jahnes K, Shapiro J, Rose K, Mathew J, Gohil A, et al. Performance of medical residents in sterile techniques during central vein catheterization randomized trial of efficacy of simulation-based training. Chest 2011;139(1):80-7.
Latif 2012 {published data only}
  • Latif RK, Bautista AF, Memon SB, Smith EA, Wang C, Wadhwa A, et al. Teaching aseptic technique for central venous access under ultrasound guidance: a randomized trial comparing didactic training alone to didactic plus simulation-based training. Anesthesia and Analgesia 2012;114(3):626-33.
Longmate 2011 {published data only}
  • Longmate AG, Ellis KS, Boyle L, Maher S, Cairns CJ, Lloyd SM, et al. Elimination of central-venous-catheter-related bloodstream infections from the intensive care unit. BMJ Quality and Safety 2011;20(2):174-80.
Lopez 2011 {published data only}
  • Lopez AC. A quality improvement program combining maximal barrier precaution compliance monitoring and daily chlorhexidine gluconate baths resulting in decreased central line bloodstream infections. Dimensions of Critical Care Nursing 2011;30(5):293-8.
Marra 2011 {published data only}
  • Marra AR, Camargo TZS, Goncalves P, Sogayar AMCB, Moura Jr DF, Guastelli LR, et al. Preventing catheter-associated urinary tract infection in the zero-tolerance era. American Journal of Infection Control 2011;39:500-5.
Miller 2011 {published data only}
  • Miller MR, Niedner MF, Huskins WC, Colantuoni E, Yenokyan G, Moss M, et al. Reducing PICU central line-associated bloodstream infections: 3-year results. Pediatrics 2011;128(5):e1077-83.
Morris 2011 {published data only}
  • Morris AC, Hay AW, Swann DG, Everingham K, McCulloch C, McNulty J, et al. Reducing ventilator-associated pneumonia in intensive care: impact of implementing a care bundle. Critical Care Medicine 2011;39(10):2218-24.
Munhoz 2012 {published data only}
  • Munoz-Price LS, Dezfulian C, Wyckoff M, Lenchus JD, Rosalsky M, Birnbach DJ, et al. Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections. Critical Care Medicine 2012;40(5):1464-9.
Papadimos 2008 {published data only}
  • Papadimos TJ, Hensley SJ, Duggan JM, Khuder SA, Borst MJ, Fath JJ, et al. Implementation of the "FASTHUG" concept decreases the incidence of ventilator-associated pneumonia in a surgical intensive care unit. Patient Safety in Surgery 2008; Vol. 2, issue 3. [DOI: 10.1186/1754-9493-2-3]
Resende 2011 {published data only}
  • Resende DS, Ó JM, Brito DV, Abdallah VO, Gontijo Filho PP. Reduction of catheter-associated bloodstream infections through procedures in newborn babies admitted in a university hospital intensive care unit in Brazil. Revista da Sociedade Brasileira de Medicina Tropical 2011; Vol. 44, issue 6:731-4.
Scales 2011 {published data only}
  • Scales DC, Dainty K, Hales B, Pinto R, Fowler RA, Adhikari NK, et al. A multifaceted intervention for quality improvement in a network of intensive care units: a cluster randomized trial. JAMA 2011;305(4):363-72.
Speroff 2011 {published data only}
Tong 2011 {published data only}
  • Tong L, Zhong Y, Feng B-L, Yu Z-Y. Preventing peripheral central venous catheter-related bloodstream infections through process management. Chinese Journal of Clinical Nutrition 2011;19(1):56-8.

Additional references

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  3. References to studies awaiting assessment
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