title: Testing the Quality Health Outcomes Model Applied to Infection Prevention in Hospitals.
abstract: To test the Quality Health Outcomes Model to investigate the relationship between health care-associated infection (HAI) prevention interventions, organizational context, and HAI outcomes using structural equation modeling.
  
  
  
  Variables for adherence to the central line bundle, organizational context, and central line-associated bloodstream infections (CLABSIs) were selected for this secondary data analysis from 614 US hospitals that participated in the Prevention of Nosocomial Infection and Cost-effectiveness-Refined study. One half of the dataset was used for exploration of the concepts, the second half for confirmation of the measurement models and testing of the structural model.
  
  
  
  The final model resulted in a good fit to the data (χ (1215) = 1906.86, P < .00; comparative fit index = 0.94; root mean square of error of approximation = 0.04). A significant relationship was noted between adherence to the central line bundle interventions and organizational context (β = 0.23, P < .01), whereas the relationship between context and CLABSIs was not significant (β = -0.20, P = .78).
  
  
  
  This study supports a relationship between greater adherence to HAI interventions and higher levels of organizational context and highlights the complexity of measuring organizational context. Given the importance of preventing HAIs, ongoing research is needed to reveal the exact aspects of context that influence interventions and outcomes.
authors.affiliation: Denver/Seattle Center of Innovation, Department of Veterans Affairs, Eastern Colorado Healthcare System, Denver (Dr Gilmartin); and College of Nursing, University of Colorado, Aurora (Dr Sousa).
authors.forename: Heather M
authors.initials: HM
authors.lastname: Gilmartin
authors.forename: Karen H
authors.initials: KH
authors.lastname: Sousa
mesh_terms: D001291:Attitude of Health Personnel; D055499:Catheter-Related Infections / Q000517:prevention & control*; D003362:Cost-Benefit Analysis; D003428:Cross Infection / Q000517:prevention & control*; D019983:Guideline Adherence; D006742:Hospital Bed Capacity; D006801:Humans; D017053:Infection Control / Q000592:standards; D007857:Leadership; D008962:Models, Theoretical; D015279:Organizational Culture; D010043:Outcome and Process Assessment, Health Care; D064872:Patient Care Bundles / Q000592:standards*; D017410:Practice Guidelines as Topic; D011787:Quality of Health Care / Q000458:organization & administration* / Q000592:standards; D012111:Residence Characteristics; D017132:Workplace / Q000523:psychology