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Knowledge about the impact of each central line insertion bundle on central line-associated bloodstream infection (CLABSI) is limited, say Tang, et al. (2014.) They describe a quality-improvement intervention, including education, central venous catheter (CVC) insertion bundle, process and outcome surveillance, that was introduced in March 2013. Outcome surveillances, including CLABSI per 1,000 catheter-days, CLABSI per 1,000 inpatient-days, and catheter utilization rates (days of catheter use divided by total inpatient-days), were measured. As a baseline measurement for a comparison, we retrospectively collected data from March 1, 2012 to Dec. 31, 2012.
During this 10-month period, there were a total of 687 CVC insertions, and 627 (91.2%) insertions were performed by intensivists. The rate of CLABSI significantly declined from 1.65 per 1000 catheter-day during the pre-intervention period to 0.65 per 1000 catheter-day post-intervention period (P = 0.039). CLABSI more likely developed in subjects in which a maximal sterile barrier was not used compared with subjects in which it was used (P = 0.03). Moreover, CVC inserted by non-intensivists were more likely to become infected than CVC inserted by intensivists (P = 0.010).
The researchers conclude that a multidisciplinary infection control intervention, including a central line insertion care bundle, can effectively reduce the rate of CLABSI. The impact of different care bundle varies, and a maximal sterile barrier precaution during catheter insertion is an essential component of the care line insertion bundle. Their research was published in BMC Infectious Diseases.
Reference: Tang HJ, Lin HL, Lin YH, Leung PO, Chuang YC and Lai CC. The impact of central line insertion bundle on central line-associated bloodstream infection. BMC Infectious Diseases 2014, 14:356 doi:10.1186/1471-2334-14-356