Walter Zingg1, Bernhard Walder, Didier Pittet. 1. Infection Control Program, Division of Anaesthesiology, University of Geneva Hospitals and Faculty of Medicine, Geneva, Switzerland. walter.zingg@hcuge.ch
Abstract
PURPOSE OF REVIEW: This review identifies important findings in the recent literature related to the prevention of central line-associated bloodstream infection (CLABSI). RECENT FINDINGS: CLABSI rates obtained through surveillance programs have decreased in recent years. Reasons for this are multifactorial: bundle interventions for practice change; technology; and pressure from benchmarking and public reporting. Many studies on the successful use of bundle strategies have been published in the past 2 years, whereas technology has somewhat disappeared from the literature. Success stories made CLABSI prevention the example of healthcare-associated infection prevention. The overwhelming success of practice change together with emerging public awareness confronts hospitals with serious implementation challenges. Fortunately, a number of implementation guidance articles were published recently, which allow hospitals to detect and overcome implementation barriers. SUMMARY: The efforts made for CLABSI prevention exemplify not only the complexity of the problem but also the creativity and--most recently--success. Although 'zero' risk may not seem a realistic goal, the number of hospitals approaching this idealistic threshold is growing. The evidence is now clear that CLABSI can be reduced most effectively by 'state-of-the-art' insertion technique and catheter care. The question today is not 'what to do' but 'how to do it'.
PURPOSE OF REVIEW: This review identifies important findings in the recent literature related to the prevention of central line-associated bloodstream infection (CLABSI). RECENT FINDINGS: CLABSI rates obtained through surveillance programs have decreased in recent years. Reasons for this are multifactorial: bundle interventions for practice change; technology; and pressure from benchmarking and public reporting. Many studies on the successful use of bundle strategies have been published in the past 2 years, whereas technology has somewhat disappeared from the literature. Success stories made CLABSI prevention the example of healthcare-associated infection prevention. The overwhelming success of practice change together with emerging public awareness confronts hospitals with serious implementation challenges. Fortunately, a number of implementation guidance articles were published recently, which allow hospitals to detect and overcome implementation barriers. SUMMARY: The efforts made for CLABSI prevention exemplify not only the complexity of the problem but also the creativity and--most recently--success. Although 'zero' risk may not seem a realistic goal, the number of hospitals approaching this idealistic threshold is growing. The evidence is now clear that CLABSI can be reduced most effectively by 'state-of-the-art' insertion technique and catheter care. The question today is not 'what to do' but 'how to do it'.
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