The University of Southampton
University of Southampton Institutional Repository
Warning ePrints Soton is experiencing an issue with some file downloads not being available. We are working hard to fix this. Please bear with us.

Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: a systematic review and meta-analysis

Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: a systematic review and meta-analysis
Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: a systematic review and meta-analysis
Background: Central line-associated bloodstream infections (CLABSIs) are associated with increased mortality, prolonged hospitalisation and increased healthcare costs. Care bundles have reduced CLABSIs in adult intensive care units (ICUs) but replication in paediatric ICUs has had inconsistent outcomes. A systematic review was performed to assess the evidence for the efficacy of care bundles in reducing CLABSIs in the neonatal unit (NNU).
Methods: MEDLINE, CINAHL and EMBASE were searched from January 2010 up to January 2017. The Cochrane Library, Web of Science, Zetoc and Ethos were searched for additional studies. Randomised controlled trials (RCTs), quasi-experimental and observational studies were eligible. The primary outcome measure was CLABSI rates per 1000 central line, or patient, days. A meta-analysis was performed using random effects modelling.
Results: Twenty-four studies were eligible for inclusion: six were performed in Europe, 12 were in North America, two in Australia and four were in low/middle-income countries. Five were observational studies and 19 were before and after quality improvement studies. No RCTs were found. Meta-analysis revealed a statistically significant reduction in CLABSIs following the introduction of care bundles (rate ratio=0.40 (CI 0.31 to 0.51), p<0.00001), which equates to a 60% reduction in CLABSI rate.
Conclusion: There is a substantial body of quasi-experimental evidence to suggest that care bundles may reduce CLABSI rates in the NNU, though it is not clear which bundle elements are effective in specific settings. Future research should focus on determining what processes promote the effective implementation of infection prevention recommendations, and which elements represent essential components of such care bundles.
1359-2998
422-429
Payne, Victoria
e8d0b37f-b13e-4990-871f-c60def347dd8
Hall, Mike
3cda0b60-23ed-4e0a-b78d-1b6f151e4de8
Prieto, Jacqueline
47dd42cd-35d5-4ece-8fc6-fdb8fe1f01cc
Johnson, Mark
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed
Payne, Victoria
e8d0b37f-b13e-4990-871f-c60def347dd8
Hall, Mike
3cda0b60-23ed-4e0a-b78d-1b6f151e4de8
Prieto, Jacqueline
47dd42cd-35d5-4ece-8fc6-fdb8fe1f01cc
Johnson, Mark
ce07b5dd-b12b-47df-a5df-cd3b9447c9ed

Payne, Victoria, Hall, Mike, Prieto, Jacqueline and Johnson, Mark (2018) Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: a systematic review and meta-analysis. Archives of Disease in Childhood - Fetal and Neonatal Edition, 103 (5), 422-429. (doi:10.1136/archdischild-2017-313362).

Record type: Article

Abstract

Background: Central line-associated bloodstream infections (CLABSIs) are associated with increased mortality, prolonged hospitalisation and increased healthcare costs. Care bundles have reduced CLABSIs in adult intensive care units (ICUs) but replication in paediatric ICUs has had inconsistent outcomes. A systematic review was performed to assess the evidence for the efficacy of care bundles in reducing CLABSIs in the neonatal unit (NNU).
Methods: MEDLINE, CINAHL and EMBASE were searched from January 2010 up to January 2017. The Cochrane Library, Web of Science, Zetoc and Ethos were searched for additional studies. Randomised controlled trials (RCTs), quasi-experimental and observational studies were eligible. The primary outcome measure was CLABSI rates per 1000 central line, or patient, days. A meta-analysis was performed using random effects modelling.
Results: Twenty-four studies were eligible for inclusion: six were performed in Europe, 12 were in North America, two in Australia and four were in low/middle-income countries. Five were observational studies and 19 were before and after quality improvement studies. No RCTs were found. Meta-analysis revealed a statistically significant reduction in CLABSIs following the introduction of care bundles (rate ratio=0.40 (CI 0.31 to 0.51), p<0.00001), which equates to a 60% reduction in CLABSI rate.
Conclusion: There is a substantial body of quasi-experimental evidence to suggest that care bundles may reduce CLABSI rates in the NNU, though it is not clear which bundle elements are effective in specific settings. Future research should focus on determining what processes promote the effective implementation of infection prevention recommendations, and which elements represent essential components of such care bundles.

Text
Care bundles to reduce central line-associated bloodstream infections in the neonatal unit: A systematic review and meta-analysis - Accepted Manuscript
Download (530kB)
Text
Supplementary information - Accepted Manuscript
Download (31kB)

More information

Accepted/In Press date: 6 September 2017
e-pub ahead of print date: 25 November 2017
Published date: August 2018

Identifiers

Local EPrints ID: 416102
URI: http://eprints.soton.ac.uk/id/eprint/416102
ISSN: 1359-2998
PURE UUID: 3c5cee7a-c839-42ff-8547-fd9cbcf9409e
ORCID for Jacqueline Prieto: ORCID iD orcid.org/0000-0002-5524-6775
ORCID for Mark Johnson: ORCID iD orcid.org/0000-0003-1829-9912

Catalogue record

Date deposited: 04 Dec 2017 17:30
Last modified: 26 Nov 2021 05:26

Export record

Altmetrics

Contributors

Author: Victoria Payne
Author: Mike Hall
Author: Mark Johnson ORCID iD

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×