Chih-Cheng Lai1, Cong-Tat Cia2, Hsiu-Tzy Chiang3, Yung-Chung Kung4, Zhi-Yuan Shi5, Yin-Ching Chuang6, Chun-Ming Lee7, Wen-Chien Ko8, Po-Ren Hsueh9. 1. Department of Intensive Care Medicine, Chi Mei Medical Center, Liouying, Tainan, Taiwan. 2. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. 3. Infection Control Center, MacKay Memorial Hospital, Taipei, Taiwan. 4. Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan. 5. Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan. 6. Department of Internal Medicine, Chi Mei Hospital, Liouying, Taiwan. 7. Infection Control Center, MacKay Memorial Hospital, Taipei, Taiwan; Department of Internal Medicine, St. Joseph's Hospital, Yunlin County, Taiwan; MacKay Junior College of Medicine, Nursing, and Management, Taipei, Taiwan. Electronic address: leecm4014@yahoo.com.tw. 8. Division of Infectious Diseases, Department of Internal Medicine, National Cheng Kung University Hospital, Tainan, Taiwan. Electronic address: winston3415@gmail.com. 9. Department of Laboratory Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taiwan; Department of Internal Medicine, National Taiwan University Hospital, National Taiwan University College of Medicine, Taipei, Taiwan. Electronic address: hsporen@ntu.edu.tw.
Abstract
BACKGROUND/ PURPOSE: This study assessed the effect of the central line bundle on the rate of central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) in Taiwan. METHODS: This national study was conducted in 27 ICUs with 404 beds total, including 15 medical ICUs, 11 surgical ICUs, and one mixed ICU. The study period was divided into two phases: a pre-intervention (between June 1, 2011 and October 31, 2011) and intervention phase (between December 1, 2011 and October 31, 2012). Outcome variables, including CLABSI rates (per 1000 catheter-days) and catheter utilization rates, were measured. RESULTS: The overall rate of CLABSI significantly decreased by 12.2% (p < 0.001) from 5.74 per 1000 catheter-days in the pre-intervention phase to 5.04 per 1000 catheter-days in the intervention phase. The catheter utilization rate decreased by 1.1% from 55.3% in the pre-intervention phase to 54.2% in the intervention phase. The decline in CLABSI varied significantly among hospital and ICU levels, except surgical ICUs (p = 0.59). CONCLUSIONS: Implementing a multidimensional central-line bundle significantly reduced the rates of CLABSI by 12.2% in nearly all participating ICUs, except surgical ICUs.
BACKGROUND/ PURPOSE: This study assessed the effect of the central line bundle on the rate of central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) in Taiwan. METHODS: This national study was conducted in 27 ICUs with 404 beds total, including 15 medical ICUs, 11 surgical ICUs, and one mixed ICU. The study period was divided into two phases: a pre-intervention (between June 1, 2011 and October 31, 2011) and intervention phase (between December 1, 2011 and October 31, 2012). Outcome variables, including CLABSI rates (per 1000 catheter-days) and catheter utilization rates, were measured. RESULTS: The overall rate of CLABSI significantly decreased by 12.2% (p < 0.001) from 5.74 per 1000 catheter-days in the pre-intervention phase to 5.04 per 1000 catheter-days in the intervention phase. The catheter utilization rate decreased by 1.1% from 55.3% in the pre-intervention phase to 54.2% in the intervention phase. The decline in CLABSI varied significantly among hospital and ICU levels, except surgical ICUs (p = 0.59). CONCLUSIONS: Implementing a multidimensional central-line bundle significantly reduced the rates of CLABSI by 12.2% in nearly all participating ICUs, except surgical ICUs.
Authors: Rasha S Almahmoud; Maha A Alfarhan; Walaa M Alanazi; Farah K Alhamidy; Hanan H Balkhy; Majid Alshamrani; Aiman El-Saed; Betule A Sairafi; Salim A Bahron Journal: J Infect Public Health Date: 2020-07-31 Impact factor: 3.718