Catherine Hocking1, Alison M Pirret. 1. Critical Care Complex, Middlemore Hospital, New Zealand. catherine.hocking@middlemore.co.nz
Abstract
OBJECTIVE: Research suggests a median central line associated bacteraemia rate of zero is achievable. This paper outlines the effectiveness of using a combined nursing and medical approach in reducing central line associated bacteraemia in a New Zealand critical care unit. METHOD: The study used a before and after audit design. Data collected between October 2007 and December 2008 prior to introducing a central line associated bacteraemia insertion bundle were compared to data collected between January 2009 and April 2011 when insertion, maintenance and high risk patient bundles were sequentially introduced. RESULTS: Data collected between October 2007 and December 2008 identified a mean central line associated bacteraemia rate of 6.43 per 1000 catheter days (range=0-12.30, Mdn=6.3, SD 3.34). Introducing the insertion bundle significantly decreased the mean central line associated bacteraemia rate to 1.50 (range=0-10.5, Mdn=0, SD=3.97, p=.02). Introducing a maintenance and high risk patient bundle sustained a median central line associated bacteraemia rate of zero over the following 12-month period. CONCLUSION: The study demonstrated a combined nursing and medical approach using central line bundles was effective in reducing the central line associated bacteraemia rate per 1000 line days and sustaining a median central line associated bacteraemia rate of zero.
OBJECTIVE: Research suggests a median central line associated bacteraemia rate of zero is achievable. This paper outlines the effectiveness of using a combined nursing and medical approach in reducing central line associated bacteraemia in a New Zealand critical care unit. METHOD: The study used a before and after audit design. Data collected between October 2007 and December 2008 prior to introducing a central line associated bacteraemia insertion bundle were compared to data collected between January 2009 and April 2011 when insertion, maintenance and high risk patient bundles were sequentially introduced. RESULTS: Data collected between October 2007 and December 2008 identified a mean central line associated bacteraemia rate of 6.43 per 1000 catheter days (range=0-12.30, Mdn=6.3, SD 3.34). Introducing the insertion bundle significantly decreased the mean central line associated bacteraemia rate to 1.50 (range=0-10.5, Mdn=0, SD=3.97, p=.02). Introducing a maintenance and high risk patient bundle sustained a median central line associated bacteraemia rate of zero over the following 12-month period. CONCLUSION: The study demonstrated a combined nursing and medical approach using central line bundles was effective in reducing the central line associated bacteraemia rate per 1000 line days and sustaining a median central line associated bacteraemia rate of zero.