Central line infection prevention bundle reduces catheter use, CLABSI
An infection prevention bundle effectively reduced dwell time, central venous catheter use and central line-associated bloodstream infection in a recent study.
“Prevention of [central line-associated bloodstream infection (CLABSI)] is a key objective for improvement of patient safety and reduction of mortality, hospital stay, and costs,” Rowena McMullan, FRACP, and Adrienne Gordon, PhD, both from the department of newborn care at Royal Prince Alfred Hospital Women and Babies, Sydney, Australia, wrote. “The aim of this study was to compare CLABSI rates before and after the introduction of the CLABSI prevention bundle to determine its effectiveness and to identify areas for further improvement.”
CLABSI can be modified through the use of health care intervention bundles, the researchers wrote. In their retrospective cohort study, McMullan and Gordon tested the effectiveness of a prevention bundle on CLABSI rates. The intervention bundle included the insertion of a central venous catheter (CVC), its maintenance, an education component, and surveillance and feedback on the program.
The researchers analyzed data from their hospital’s neonatal ICU for all of 2012 (baseline period) and from August 2013 through July 2014 (intervention period). The researchers specifically reviewed areas where CLABSI prevention failed. Based on information from the neonatal clinical database, the researchers determined which infants had a CVC placed during admission and details on any bloodstream infection. These data were reviewed and compared for both study periods.
In the intervention phase, the number of CVCs inserted was reduced, and the central line utilization rate was 0.16 compared with 0.2 at baseline (P < .0001). CVC dwell time also decreased from 7.3 days (95% CI, 4-10.4) during the baseline period to 6 days (95% CI, 5-11.8). Further, the incidence of CLABSI was reduced, declining from11.5 per 1,000 central-line days during baseline to 1.2 per 1,000 central-line days (P < .0001) for peripherally inserted CVCs during the intervention.
“The reductions in the number of CVCs inserted, CVC dwell time, and CLABSI rates provide further data in support of CLABSI prevention intervention bundles,” the researchers wrote. “The reduction of health care-associated infection is a nationally important issue, and we have demonstrated the substantial impact that can be made within a single unit with a bundle of interventions.” – by Rafi Naseer
Disclosure: The researchers report no relevant financial disclosures.