Impact of two bundles on central catheter-related bloodstream infection in critically ill patients

Abstract

Objective:To evaluate the impact of the implementation of insertion and maintenance bundles on the rates of catheter-related bloodstream infection in an intensive care unit. Method:This is a quasi-experimental, before-and-after study with a non-equivalent control group. During a six-month period, insertion and maintenance bundles for the central venous catheters were implemented. Supervision guidelines were developed to assess compliance with the bundle and catheter characteristics. Results:A total of 444 central catheters corresponding to 390 patients were observed, of which 68.7% were inserted in the unit. The maintenance and insertion bundles reached 62.9% and 94.7% compliance, respectively, and 50.7% of the insertions were supervised. It was possible to observe a 54.5% decrease in the rate of central catheter infection (3.48 vs 1.52 x 1000 days/catheter, p<0.05) when compared with the control group. Conclusion:The simultaneous implementation of insertion and maintenance bundles has a positive impact on the reduction of catheter-related bloodstream infection; therefore it is an efficient alternative to improve the quality and safety of care in high complexity units.

Insertion of central vascular catheter: adherence to infection prevention bundle

“…Regarding the overall incidence density of the PBSI, a study that evaluated the implementation of bundles to control CVC-related infections showed a reduction in the incidence of bloodstream infections from 2.4% to 0.9% in the pre-and post-intervention periods, respectively (21) , corroborating with the results of this research.…”

“…Regarding the hand hygiene component, an observational research evidenced the execution of this practice in only 10.7% of the observations made (16) , which brings conflicting results with this study, in which this practice was verified in 100% of the cases. It is understood that hand hygiene is one of the most important measures to prevent infections, guaranteeing a safe care for both patients and health professionals, as shown in a study (21) , which obtained a reduction in the infection rate from 7.8 to 2.3 episodes/1,000 CVC per day.…”

Acinetobacter baumannii infection in a medical intensive care unit: The impact of strict infection control

“…[10] A study that investigated the impact of bundles to reduce sepsis in the ICU showed a significant reduction in the rate of central catheter-related bloodstream infection. [11] Similarly, decreased rates of CAUTI and VAP have been reported in the ICU after the implementation of the respective bundles. [12,13] Overall, the implementation of the various bundles appears to have contributed significantly to reducing the incidence of sepsis in the ICU, especially with regard to resistant bacteria such as A. baumannii, and helps to decrease the spread of infection among ICU patients.…”

The Effect of Central Venous Catheter Maintenance Bundle Implementation on Central Line Associated Infection Rate in the Intensive Care Unit

“…A systematic approach on a daily basis using daily goals sheet, nurse-driven protocols, electronic reminders, or multidisciplinary catheter rounds are possible interventions [6]. The simultaneous implementation of insertion and maintenance bundles has a positive impact on the reduction of catheter-related bloodstream infection [7].…”