BACKGROUND: Central line-associated bloodstream infections (CLABSI) related to insertion and device care in intensive care units are frequent and preventable events. AIM: To evaluate the reduction in the rate of CLABSI through implementation of an insertion bundle. METHODS: A study was conducted in the Adult-ICU at the University Hospital of Neiva comparing a pre-interventional period with an interventional one, each lasting 6 months; the intervention consisting of implementing a bundle of measures for the insertion of central venous catheters (CVC). In the pre-intervention period (2010) the rate of CLABSI and the population's characteristics were evaluated. The bundle for the insertion of the CVC consisted in: hands hygiene, use of 2% clorhexidine, maximum sterile barriers and avoiding femoral access. RESULTS: The rate of CLABSI decreased from 5.56 to 3.26 per 1000 catheter days. The length of ICU stay and catheter duration were associated with a higher risk of infection associated to these devices (p < 0.05). Compliance with the bundle is a protective factor against the development of CLABSI (OR 0.45, p = 0.615). The staff adherence to the bundle was over 80%. CONCLUSION: Implementing a Central Line Insertion Bundle proved to be a useful measure in prevention of CLABSI in our hospital. This strategy could be implemented in other hospitals of similar complexity.
BACKGROUND: Central line-associated bloodstream infections (CLABSI) related to insertion and device care in intensive care units are frequent and preventable events. AIM: To evaluate the reduction in the rate of CLABSI through implementation of an insertion bundle. METHODS: A study was conducted in the Adult-ICU at the University Hospital of Neiva comparing a pre-interventional period with an interventional one, each lasting 6 months; the intervention consisting of implementing a bundle of measures for the insertion of central venous catheters (CVC). In the pre-intervention period (2010) the rate of CLABSI and the population's characteristics were evaluated. The bundle for the insertion of the CVC consisted in: hands hygiene, use of 2% clorhexidine, maximum sterile barriers and avoiding femoral access. RESULTS: The rate of CLABSI decreased from 5.56 to 3.26 per 1000 catheter days. The length of ICU stay and catheter duration were associated with a higher risk of infection associated to these devices (p < 0.05). Compliance with the bundle is a protective factor against the development of CLABSI (OR 0.45, p = 0.615). The staff adherence to the bundle was over 80%. CONCLUSION: Implementing a Central Line Insertion Bundle proved to be a useful measure in prevention of CLABSI in our hospital. This strategy could be implemented in other hospitals of similar complexity.
Authors: Kyoung Hwa Lee; Nan Hyoung Cho; Su Jin Jeong; Mi Na Kim; Sang Hoon Han; Young Goo Song Journal: Yonsei Med J Date: 2018-05 Impact factor: 2.759