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Effectiveness of non-pharmacological interventions for the prevention of bloodstream infections in infants admitted to a neonatal intensive care unit: A systematic review.
MedLine Citation:
PMID:  22385913     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: Bloodstream infections are associated with increased morbidity and mortality in very low birth weight infants admitted to neonatal intensive care units. OBJECTIVE: To evaluate the available evidence for the effectiveness of non-pharmacological bloodsteam infection-preventive measures in infants admitted to a neonatal intensive care unit. DESIGN: A systematic review of randomized, controlled trials, controlled clinical trials, interrupted time series and pretest-posttest studies. DATA SOURCES: PubMed, CINAHL, Web-of-Science, Cochrane Central Register of Controlled Trials, and Embase were searched. REVIEW METHODS: The systematic review was carried out according to the guidelines of the Center for Reviews and Dissemination. The methodological quality of the individual studies was evaluated with the quantitative evaluation form of McMaster University. The review included randomized, controlled trials, controlled clinical trials, interrupted time series, and pre-posttest studies published from January 1990 to January 2011. Quantitative pooling of the results was not feasible due to the high heterogeneity of the interventions, methods and outcome measures. Instead, we present the studies in tabular form and provide a narrative account of the study characteristics and results. RESULTS: Fifteen studies out of 288 generated hits were selected and categorized as research on: hand hygiene (5), intravenous (IV) bundles (4), closed IV sets/patches/filters (4), surveillance (1), and percutaneously inserted central catheter teams (1). IV bundles including proper insertion and proper maintenance showed to be the most effective intervention for preventing bloodstream infection in infants; in three out of four studies on IV bundles, a statistically significant reduction of bloodstream infections was mentioned. CONCLUSIONS: Although the methodological quality of most studies was not very robust, we conclude that IV bundles may decrease bloodstream infections in infants. However, differences in IV bundle components and in practices limited the underpinning evidence. There is limited evidence that the introduction of a percutaneously inserted central catheter team results in bloodstream infection reduction. Hand hygiene promotion increases hand hygiene among healthcare workers, but there is inconclusive evidence that this intervention subsequently leads to a bloodstream infection reduction in infants. Future studies must be well designed, with standardized outcome measures.
Authors:
Onno Helder; Agnes van den Hoogen; Coby de Boer; Johannes van Goudoever; Malgosia Verboon-Maciolek; René Kornelisse
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-2-29
Journal Detail:
Title:  International journal of nursing studies     Volume:  -     ISSN:  1873-491X     ISO Abbreviation:  -     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-3-5     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0400675     Medline TA:  Int J Nurs Stud     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2012 Elsevier Ltd. All rights reserved.
Affiliation:
Department of Pediatrics, Division of Neonatology, Erasmus MC - Sophia Children's Hospital, Erasmus University Medical Center, Rotterdam, The Netherlands.
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