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Intervention targeting healthcare professional to improve compliance with device-related infection control recommendations in acute healthcare facilities


Currently, between 5 to 10 percent of patients admitted to acute care hospitals in United States, Brazil,Australasian and most European countries, acquire one or more infections. Hospital acquired infections result in excess mortality, prolonged lengths of hospitalisation and increase medical costs. The role of devices on HAI can be showed by the fact that 60% to 87% of primary bloodstream infections are associated with central lines, 86% of nosocomial pneumonia is associated with mechanical ventilation, and 80%-95% of urinary tract infections are associated with urinary catheters .Some strategies have been already proven effective for preventing device-related infections and ensuing morbidity, mortality and cost.It is known that not all HAI are avoidable however, it has been estimated the application of existing knowledge and adherence to good practice can contribute to prevent 30% of them.Some studies have evaluated different interventions to improve the compliance of healthcare professionals to infection control measures. Formal device removal policy, reminders, audits, feed back and educational intervention of professionals have been shown to decrease the rates of device-related infections. The objective of this project is carrying out a Systematic Review to determine the effectiveness and efficiency of different interventions, alone or in combination, targeting healthcare professionals, to improve compliance with device-related infection control recommendations. Types of studies:all randomised and quasi-randomised controlled trials (RCTs/CCTs), controlled before and after (CBAs) studies (with contemporaneous data collection) and interrupted time series (ITSs) studies (with defined point in time when the intervention occurred and at least three data points before and after implementation of intervention) will be included. Studies published in any language will be includedTypes of participants:health care professionals involved with the insertion, maintenance and prevention of device-related infections Types of interventions:any intervention aimed to avoid the use, to decrease the length of use or to improve adoption of measures to prevent device-related infections. The comparative groups can receive no intervention or different interventions of the experimental group.Types of outcome measures: number of patients in which device was inserted, length of devices use, compliance with infection control recommendation for insertion, manutenance and device-related infections prevention, proportion/rate of device-related infections,mortality associate with devices-related infections and costThe following electronic databases will be searched: DARE, Cochrane, MEDLINE, EMBASE, CINAHL. This review will be conducted in accordance with the general EPOC methods.Two reviewers will independently screen all titles and abstracts retrieved in the search to identify relevant papers. The data extraction will be done using a standard templante.Where appropriate results of comparable groups of trials (similar study design, intervention and outcomes) will be pooled. Heterogeneity within similar study designs will be explored. We will perform subgroup analyses if there are sufficient numbers of studies (AU)

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(References retrieved automatically from Web of Science and SciELO through information on FAPESP grants and their corresponding numbers as mentioned in the publications by the authors)
FLODGREN, GERD; CONTERNO, LUCIENI O.; MAYHEW, ALAIN; OMAR, OMAR; PEREIRA, CRESIO ROMEU; SHEPPERD, SASHA. Interventions to improve professional adherence to guidelines for prevention of device-related infections. Cochrane Database of Systematic Reviews, n. 3, . (06/07217-1)

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