Faculty Collaboration Database

Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections. Crit Care Med 2012 May;40(5):1464-9

Date

04/19/2012

Pubmed ID

22511128

DOI

10.1097/CCM.0b013e31823e9f5b

Scopus ID

2-s2.0-84860241768 (requires institutional sign-in at Scopus site)   37 Citations

Abstract

OBJECTIVE: Determine the impact of three stepwise interventions on the rate of central catheter-associated bloodstream infections.

DESIGN: Quasi-experimental study.

SETTING: Three surgical intensive care units (general surgery, trauma, and neurosurgery) at a 1500-bed county teaching hospital in the Miami metro area.

PATIENTS: All consecutive central catheter-associated bloodstream infection cases as determined by the Infection Control Department.

INTERVENTIONS: Three interventions aimed at catheter maintenance were implemented at different times in the units: chlorhexidine "scrub-the-hub," chlorhexidine daily baths, and daily nursing rounds aimed at assuring compliance with an intensive care unit goal-oriented checklist.

MEASUREMENTS AND MAIN RESULTS: The primary outcome was the monthly intensive care unit rate of central catheter-associated bloodstream infections (infections per 1000 central catheter days). Over 33 months of follow-up (July 2008 to March 2011), we found decreased rates in each of the three intensive care units evaluated during the interventions, especially after implementation of chlorhexidine daily baths. Rates in unit A decreased from a rate of 8.6 to 0.5, unit B from 6.9 to 1.6, and unit C from 7.8 to 0.6. Secondary bloodstream infection rates remained unchanged throughout the observation period in units A and B; however, unit C had a decrease in its rates over time.

CONCLUSIONS: We report the progressive reduction of central catheter-associated bloodstream infection rates after the stepwise implementation of chlorhexidine "scrub-the-hub" and daily baths in surgical intensive care units, suggesting effectiveness of these interventions.

Author List

Munoz-Price LS, Dezfulian C, Wyckoff M, Lenchus JD, Rosalsky M, Birnbach DJ, Arheart KL

MESH terms used to index this publication - Major topics in bold

Catheter-Related Infections
Catheterization, Central Venous
Checklist
Chlorhexidine
Cross Infection
Disinfectants
Humans
Intensive Care Units