Abraham E Wei1, Ronald J Markert1, Christopher Connelly2, Hari Polenakovik3. 1. Department of Internal Medicine, Wright State University Boonshoft School of Medicine, USA. 2. Department of Clinical Analytics, Miami Valley Hospital, USA. 3. Division of Infectious Diseases, Wright State University Boonshoft School of Medicine, USA.
Abstract
BACKGROUND: Central line-associated bloodstream infection (CLABSI) is a preventable medical condition that results in increased patient morbidity and mortality. We describe the impact of various quality improvement interventions on the incidence of CLABSI in an 848-bed community teaching hospital from 1 January 2013 to 31 December 2017. AIM: To reduce CLABSI rates after implementation of a comprehensive central line insertion and maintenance bundle. METHODS: A comprehensive bundle of interventions was implemented incorporating the standard US Centers for Disease Control and Prevention bundle with additional measures such as root-cause analysis of all CLABSI cases, use of passive disinfection caps on vascular access ports, standardisation of weekly central venous catheter (CVC) site dressing changes, and use of antithrombotic and antimicrobial-coated CVCs with fewer lumens. A retrospective study evaluated CLABSI rates and time of CLABSI onset after CVC placement in both intensive care unit (ICU) and non-ICU settings. RESULTS: The annual number of CLABSI cases declined 68% (34 to 11 patients) from 2013 to 2017. There was a 30% decline in CVC days from years 2014 to 2017. Over the same period, CLABSI cases per 1000 CVC days decreased from 0.624 to 0.362: a 42% decline. CONCLUSION: Following the implementation of a comprehensive bundle of interventions for CVC insertion and maintenance, we found a reduction in rates of CLABSI.
BACKGROUND: Central line-associated bloodstream infection (CLABSI) is a preventable medical condition that results in increased patient morbidity and mortality. We describe the impact of various quality improvement interventions on the incidence of CLABSI in an 848-bed community teaching hospital from 1 January 2013 to 31 December 2017. AIM: To reduce CLABSI rates after implementation of a comprehensive central line insertion and maintenance bundle. METHODS: A comprehensive bundle of interventions was implemented incorporating the standard US Centers for Disease Control and Prevention bundle with additional measures such as root-cause analysis of all CLABSI cases, use of passive disinfection caps on vascular access ports, standardisation of weekly central venous catheter (CVC) site dressing changes, and use of antithrombotic and antimicrobial-coated CVCs with fewer lumens. A retrospective study evaluated CLABSI rates and time of CLABSI onset after CVC placement in both intensive care unit (ICU) and non-ICU settings. RESULTS: The annual number of CLABSI cases declined 68% (34 to 11 patients) from 2013 to 2017. There was a 30% decline in CVC days from years 2014 to 2017. Over the same period, CLABSI cases per 1000 CVC days decreased from 0.624 to 0.362: a 42% decline. CONCLUSION: Following the implementation of a comprehensive bundle of interventions for CVC insertion and maintenance, we found a reduction in rates of CLABSI.
Authors: Michael W Climo; Deborah S Yokoe; David K Warren; Trish M Perl; Maureen Bolon; Loreen A Herwaldt; Robert A Weinstein; Kent A Sepkowitz; John A Jernigan; Kakotan Sanogo; Edward S Wong Journal: N Engl J Med Date: 2013-02-07 Impact factor: 91.245
Authors: Cameron Dezfulian; James Lavelle; Brahmajee K Nallamothu; Samuel R Kaufman; Sanjay Saint Journal: Crit Care Med Date: 2003-09 Impact factor: 7.598
Authors: Crystal H Son; Titus L Daniels; Janet A Eagan; Michael B Edmond; Neil O Fishman; Thomas G Fraser; Mini Kamboj; Lisa L Maragakis; Sapna A Mehta; Trish M Perl; Michael S Phillips; Connie S Price; Thomas R Talbot; Stephen J Wilson; Kent A Sepkowitz Journal: Infect Control Hosp Epidemiol Date: 2012-07-24 Impact factor: 3.254
Authors: Florian Salm; Frank Schwab; Michael Behnke; Frank M Brunkhorst; André Scherag; Christine Geffers; Petra Gastmeier Journal: Antimicrob Resist Infect Control Date: 2018-11-21 Impact factor: 4.887