Document Detail

Nosocomial infection reduction in VLBW infants with a statewide quality-improvement model.
MedLine Citation:
PMID:  21339273     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To evaluate the effectiveness of the California Perinatal Quality Care Collaborative quality-improvement model using a toolkit supplemented by workshops and Web casts in decreasing nosocomial infections in very low birth weight infants.
DESIGN: This was a retrospective cohort study of continuous California Perinatal Quality Care Collaborative members' data during the years 2002-2006. The primary dependent variable was nosocomial infection, defined as a late bacterial or coagulase-negative staphylococcal infection diagnosed after the age of 3 days by positive blood/cerebro-spinal fluid culture(s) and clinical criteria. The primary independent variable of interest was voluntary attendance at the toolkit's introductory event, a direct indicator that at least 1 member of an NICU team had been personally exposed to the toolkit's features rather than being only notified of its availability. The intervention's effects were assessed using a multivariable logistic regression model that risk adjusted for selected demographic and clinical factors.
RESULTS: During the study period, 7733 eligible very low birth weight infants were born in 27 quality-improvement participant hospitals and 4512 very low birth weight infants were born in 27 non-quality-improvement participant hospitals. For the entire cohort, the rate of nosocomial infection decreased from 16.9% in 2002 to 14.5% in 2006. For infants admitted to NICUs participating in at least 1 quality-improvement event, there was an associated decreased risk of nosocomial infection (odds ratio: 0.81 [95% confidence interval: 0.68-0.96]) compared with those admitted to nonparticipating hospitals.
CONCLUSIONS: The structured intervention approach to quality improvement in the NICU setting, using a toolkit along with attendance at a workshop and/or Web cast, is an effective means by which to improve care outcomes.
David D Wirtschafter; Richard J Powers; Janet S Pettit; Henry C Lee; W John Boscardin; Mohammad Ahmad Subeh; Jeffrey B Gould
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Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2011-02-21
Journal Detail:
Title:  Pediatrics     Volume:  127     ISSN:  1098-4275     ISO Abbreviation:  Pediatrics     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-02     Completed Date:  2011-05-10     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  0376422     Medline TA:  Pediatrics     Country:  United States    
Other Details:
Languages:  eng     Pagination:  419-26     Citation Subset:  AIM; IM    
David D. Wirtschafter, MD, Inc, San Jose, California, USA.
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MeSH Terms
California / epidemiology
Cross Infection / epidemiology*
Infant, Newborn
Infant, Premature, Diseases / epidemiology*
Infant, Very Low Birth Weight*
Intensive Care Units, Neonatal / standards*
Quality Assurance, Health Care / methods*
Quality Improvement*
Grant Support
Comment In:
Pediatrics. 2011 Mar;127(3):571-2   [PMID:  21339272 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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