Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster-randomized multicentre study to reduce central venous catheter-related bloodstream infections

Purpose To test the effectiveness of a central venous catheter (CVC) insertion strategy and a hand hygiene (HH) improvement strategy to prevent central venous catheter-related bloodstream infections (CRBSI) in European intensive care units (ICUs), measuring both process and outcome indicators. Metho...

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Published in:Intensive care medicine 2018, Vol.44 (1), p.48-60
Main Authors: van der Kooi, Tjallie, Sax, Hugo, Pittet, Didier, van Dissel, Jaap, van Benthem, Birgit, Walder, Bernhard, Cartier, Vanessa, Clack, Lauren, de Greeff, Sabine, Wolkewitz, Martin, Hieke, Stefanie, Boshuizen, Hendriek, van de Kassteele, Jan, Van den Abeele, Annemie, Boo, Teck Wee, Diab-Elschahawi, Magda, Dumpis, Uga, Ghita, Camelia, FitzGerald, Susan, Lejko, Tatjana, Leleu, Kris, Martinez, Mercedes Palomar, Paniara, Olga, Patyi, Márta, Schab, Paweł, Raglio, Annibale, Szilágyi, Emese, Ziętkiewicz, Mirosław, Wu, Albert W., Grundmann, Hajo, Zingg, Walter
Format: Article
Language:English
Subjects:
Adult
Advertising campaigns
Aged
Anesthesiology
Bacteremia
Behavior modification
Catheter-Related Infections - prevention & control
Catheterization
Catheterization, Central Venous
Catheters
Central Venous Catheters
Clusters
Compliance
Critical Care Medicine
Cross Infection - prevention & control
Density
Emergency Medicine
Europe
Female
Hand Hygiene
Health aspects
Hospital patients
Hospitals
Humans
Hygiene
Incidence
Indicators
Infection
Infections
Insertion
Intensive
Intensive care units
Intervention
Male
Medical instruments
Medicine
Medicine & Public Health
Middle Aged
Original
Pain Medicine
Pediatrics
Personal hygiene
Pneumology/Respiratory System
Prevention
Prospective Studies
Quality control
Randomization
Strategy
Training
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Summary:Purpose To test the effectiveness of a central venous catheter (CVC) insertion strategy and a hand hygiene (HH) improvement strategy to prevent central venous catheter-related bloodstream infections (CRBSI) in European intensive care units (ICUs), measuring both process and outcome indicators. Methods Adult ICUs from 14 hospitals in 11 European countries participated in this stepped-wedge cluster randomised controlled multicentre intervention study. After a 6 month baseline, three hospitals were randomised to one of three interventions every quarter: (1) CVC insertion strategy (CVCi); (2) HH promotion strategy (HHi); and (3) both interventions combined (COMBi). Primary outcome was prospective CRBSI incidence density. Secondary outcomes were a CVC insertion score and HH compliance. Results Overall 25,348 patients with 35,831 CVCs were included. CRBSI incidence density decreased from 2.4/1000 CVC-days at baseline to 0.9/1000 ( p  
ISSN:0342-4642
1432-1238
DOI:10.1007/s00134-017-5007-6