- Poster presentation
- Open access
- Published:
Effects of a multifaceted quality improvement intervention in reducing mortality and bloodstream infection in ICUs: insights from the QUALITI initiative
Critical Care volume 16, Article number: P65 (2012)
Introduction
Our objective was to evaluate if the implementation of a multifaceted intervention program for quality improvement in ICUs of nonacademic hospitals would decrease mortality and the catheter-related bloodstream infection rate (CRBSI).
Methods
A clinical practice improvement program involving 17 Brazilian ICUs of nonacademic public hospitals located far from major economic centers under coordination of a not-for-profit private hospital with the support of Brazilian Ministry of Health. We implemented the following interventions: (1) hospital visits to assess the facilities, human resources and processes; (2) workshop with hospital directors and ICU coordinators to elaborate improvement proposals based on the initial visit findings; (3) multidisciplinary videoconference lectures every 3 weeks about critical care medicine assistance and quality issues; (4) website containing project educational material, videoconference recordings, and an evidence-based practice course; (5) subscription of an electronic clinical information resource for all participating hospitals (UpToDate®); (6) 3-day workshop to share the coordinating institution quality improvement practices with directors and ICU coordinators from the 17 participant institutions; (7) 3-day nursing visits from the coordinating hospital to perform advice on care practice; (8) basic life support courses, 56 vacancies per hospital, and fundamentals of critical care support, 30 vacancies; and (9) implementation of a web-based system to collect ICU and hospital mortality, SAPS3, standardized-mortality ratio (SMR) and CRBSI after June 2011. We assessed variation of SMR and CRBSI on time using weighted linear regression, and variation of mortality on time using generalized-estimating equations.
Results
The results are presented in Table 1.
Conclusion
A multifaceted intervention program applied to a network of ICUs in nonacademic public hospitals reduced mortality.
Author information
Authors and Affiliations
Rights and permissions
This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
About this article
Cite this article
Cavalcanti, A., Othero, J., Mouro, J. et al. Effects of a multifaceted quality improvement intervention in reducing mortality and bloodstream infection in ICUs: insights from the QUALITI initiative. Crit Care 16 (Suppl 1), P65 (2012). https://doi.org/10.1186/cc10672
Published:
DOI: https://doi.org/10.1186/cc10672