Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era

Alexandre R Marra; Ruy Guilherme Rodrigues Cal; Marcelino Souza Durão Jr; Luci Correa; Luciana Reis Guastelli; Denis Faria Moura; Michael B Edmond; Oscar Fernando Pavão dos Santos

doi:10.1016/j.ajic.2009.11.012

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Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era

Journal article

Peer reviewed

Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era

Alexandre R Marra, Ruy Guilherme Rodrigues Cal, Marcelino Souza Durão Jr, Luci Correa, Luciana Reis Guastelli, Denis Faria Moura, Michael B Edmond and Oscar Fernando Pavão dos Santos

AJIC: American Journal of Infection Control, Vol.38(6), pp.434-439

2010

DOI: 10.1016/j.ajic.2009.11.012

PMID: 20226570

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Abstract

Central line-associated bloodstream infection (CLABSI) is one of the most important health care-associated infections in the critical care setting. A quasiexperimental study involving multiple interventions to reduce the incidence of CLABSI was conducted in a medical-surgical intensive care unit (ICU) and in 2 step-down units (SDUs). From March 2005 to March 2007 (phase 1 [P1]), some Centers for Disease Control and Prevention evidence-based practices were implemented. From April 2007 to April 2009 (P2), we intervened in these processes at the same time that performance monitoring was occurring at the bedside, and we implemented the Institute for Healthcare Improvement central line bundle for all ICU and SDU patients requiring central venous lines. The mean incidence density of CLABSI per 1000 catheter-days in the ICU was 6.4 in phase 1 and 3.2 in phase 2, P < .001. The mean incidence density of CLABSI per 1000 catheter-days in the SDUs was 4.1 in phase 1 and 1.6 in phase 2, P = .005. These results suggest that reducing CLABSI rates in an ICU setting is a complex process that involves multiple performance measures and interventions that can also be applied to SDU settings.

Epidemiology

step-down unit

central line bundle

Bloodstream infection

intensive care unit

central venous catheter

prevention

zero tolerance

Details

Title: Subtitle: Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era
Creators: Alexandre R Marra - Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Ruy Guilherme Rodrigues Cal - Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Marcelino Souza Durão Jr - Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Luci Correa - Infection Control Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Luciana Reis Guastelli - Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Denis Faria Moura - Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Michael B Edmond - Department of Internal Medicine, Virginia Commonwealth University School of Medicine, Richmond, VA
Oscar Fernando Pavão dos Santos - Intensive Care Unit, Hospital Israelita Albert Einstein, São Paulo, Brazil
Resource Type: Journal article
Publication Details: AJIC: American Journal of Infection Control, Vol.38(6), pp.434-439
Publisher: Mosby, Inc
DOI: 10.1016/j.ajic.2009.11.012
PMID: 20226570
ISSN: 0196-6553
eISSN: 1527-3296
Language: English
Date published: 2010
Academic Unit: Internal Medicine
Record Identifier: 9983905644502771

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