Central line bundle implementation in US intensive care units and impact on bloodstream infections

E Yoko Furuya; Andrew Dick; Eli N Perencevich; Monika Pogorzelska; Donald Goldmann; Patricia W Stone

doi:10.1371/journal.pone.0015452

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Central line bundle implementation in US intensive care units and impact on bloodstream infections

Journal article

Open access

Peer reviewed

Central line bundle implementation in US intensive care units and impact on bloodstream infections

E Yoko Furuya, Andrew Dick, Eli N Perencevich, Monika Pogorzelska, Donald Goldmann and Patricia W Stone

PloS one, Vol.6(1), pp.e15452-e15452

01/18/2011

DOI: 10.1371/journal.pone.0015452

PMCID: PMC3022589

PMID: 21267440

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Abstract

Central line-associated bloodstream infections (CLABSI) represent a serious patient safety issue. To prevent these infections, bundled interventions are increasingly recommended. We examine the extent of adoption of Central Line (CL) Bundle elements throughout US intensive care units (ICU) and determine their effectiveness in preventing CLABSIs. In this cross-sectional study, National Healthcare Safety Network (NHSN) hospitals provided the following: ICU-specific NHSN-reported rates of CLABSI/1,000 central line days; policies and compliance rates regarding bundle components; and other setting characteristics. In 250 hospitals the mean CLABSI rate was 2.1 per 1000 central line days and 49% reported having a written CL Bundle policy. However, of those that monitored compliance, only 38% reported very high compliance with the CL Bundle. Only when an ICU had a policy, monitored compliance, and had ≥ 95% compliance did CLABSI rates decrease. Complying with any one of three CL Bundle elements resulted in decreased CLABSI rates (β = -1.029, p = 0.015). If an ICU without good bundle compliance achieved high compliance with any one bundle element, we estimated that its CLABSI rate would decrease by 38%. In NHSN hospitals across the US, the CL Bundle is associated with lower infection rates only when compliance is high. Hospitals must target improving bundle implementation and compliance as opposed to simply instituting policies.

United States

Blood-Borne Pathogens

Intensive Care Units - standards

Bacteremia - prevention & control

Cross-Sectional Studies

Humans

Catheters, Indwelling - microbiology

Catheterization, Central Venous - instrumentation

Infection Control - methods

Catheter-Related Infections - prevention & control

Catheterization, Central Venous - adverse effects

Details

Title: Subtitle: Central line bundle implementation in US intensive care units and impact on bloodstream infections
Creators: E Yoko Furuya - Division of Infectious Diseases, Columbia University College of Physicians and Surgeons, New York, New York, United States of America
Andrew Dick
Eli N Perencevich
Monika Pogorzelska
Donald Goldmann
Patricia W Stone
Resource Type: Journal article
Publication Details: PloS one, Vol.6(1), pp.e15452-e15452
DOI: 10.1371/journal.pone.0015452
PMID: 21267440
PMCID: PMC3022589
NLM abbreviation: PLoS One
ISSN: 1932-6203
eISSN: 1932-6203
Publisher: United States
Grant note: R01 NR010107-03 / NINR NIH HHS R01 NR010107 / NINR NIH HHS R01 NR010107-04 / NINR NIH HHS R01NR010107 / NINR NIH HHS
Language: English
Date published: 01/18/2011
Academic Unit: Epidemiology; Internal Medicine
Record Identifier: 9983779291502771

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