An evidence-based bundle improves the quality of care and outcomes of patients with candidaemia
- Creators
- Cardozo C.
- Cuervo G.
- Salavert M.
- Merino P.
- Gioia F.
- Fernandez-Ruiz M.
- Lopez-Cortes L. E.
- Escola-Verge L.
- Montejo M.
- Munoz P.
- Aguilar-Guisado M.
- Puerta-Alcalde P.
- Tasias M.
- Ruiz-Gaitan A.
- Gonzalez F.
- Puig-Asensio M.
- Vena A.
- Marco F.
- Peman J.
- Fortun J.
- Aguado J. M.
- Almirante B.
- Soriano A.
- Carratala J.
- Garcia-Vidal C.
- Martinez J. A.
- Morata L.
- Rodriguez-Nunez O.
- Guerrero M. A.
- Ayats J.
- Grau I.
- Calabuig E.
- Castro I.
- Cuellar S.
- Martin-Davila P.
- Gomez-Garcia De La Pedrosa E.
- Perez-Ayala A.
- Losada I.
- Navarro M. D.
- Suarez A. I.
- Martin-Gomez M. T.
- Rodriguez-Alvarez R.
- Lopez-Soira L.
- Bouza E.
- Guinea J.
- Martin C.
- Others:
- Cardozo, C.
- Cuervo, G.
- Salavert, M.
- Merino, P.
- Gioia, F.
- Fernandez-Ruiz, M.
- Lopez-Cortes, L. E.
- Escola-Verge, L.
- Montejo, M.
- Munoz, P.
- Aguilar-Guisado, M.
- Puerta-Alcalde, P.
- Tasias, M.
- Ruiz-Gaitan, A.
- Gonzalez, F.
- Puig-Asensio, M.
- Vena, A.
- Marco, F.
- Peman, J.
- Fortun, J.
- Aguado, J. M.
- Almirante, B.
- Soriano, A.
- Carratala, J.
- Garcia-Vidal, C.
- Martinez, J. A.
- Morata, L.
- Rodriguez-Nunez, O.
- Guerrero, M. A.
- Ayats, J.
- Grau, I.
- Calabuig, E.
- Castro, I.
- Cuellar, S.
- Martin-Davila, P.
- Gomez-Garcia De La Pedrosa, E.
- Perez-Ayala, A.
- Losada, I.
- Navarro, M. D.
- Suarez, A. I.
- Martin-Gomez, M. T.
- Rodriguez-Alvarez, R.
- Lopez-Soira, L.
- Bouza, E.
- Guinea, J.
- Martin, C.
Description
Background: Candidaemia is a leading cause of bloodstream infections in hospitalized patients all over the world. It remains associated with high mortality. Objectives: To assess the impact of implementing an evidence-based package of measures (bundle) on the quality of care and outcomes of candidaemia. Methods: A systematic review of the literature was performed to identify measures related to better outcomes in candidaemia. Eight quality-of-care indicators (QCIs) were identified and a set of written recommendations (early treatment, echinocandins in septic shock, source control, follow-up blood culture, ophthalmoscopy, echocardiography, de-escalation, length of treatment) was prospectively implemented. The study was performed in 11 tertiary hospitals in Spain. A quasi-experimental design before and during bundle implementation (September 2016 to February 2018) was used. For the pre-intervention period, data from the prospective national surveillance were used (May 2010 to April 2011). Results: A total of 385 and 263 episodes were included in the pre-intervention and intervention groups, respectively. Adherence to all QCIs improved in the intervention group. The intervention group had a decrease in early (OR 0.46; 95% CI 0.23-0.89; P = 0.022) and overall (OR 0.61; 95% CI 0.4-0.94; P = 0.023) mortality after controlling for potential confounders. Conclusions: Implementing a structured, evidence-based intervention bundle significantly improved patient care and early and overall mortality in patients with candidaemia. Institutions should embrace this objective strategy and use the bundle as a means to measure high-quality medical care of patients.
Additional details
- URL
- http://hdl.handle.net/11567/1073466
- URN
- urn:oai:iris.unige.it:11567/1073466
- Origin repository
- UNIGE