Long-term sustainability of zero central-line associated bloodstream infections is possible with high compliance with care bundle elements

Abstract

Central-line-associated bloodstream infection (CLABSI) is one of the most important problems in intensive care units (ICUs) worldwide. A bundle of CLABSI care measures was introduced at a 13-bed medical/ surgical ICU in Kocaeli, Turkey in January 2010. Compliance rates with the bundle were measured at the beginning of the third quarter of 2010 until June 2013 and compared with CLABSI rates. During the post-intervention period, of 2196 ICU patients, 732 lines placed for 4366 line-days were monitored. Feedback to staff reinforced a culture of patient safety in the ICU. Infection rates remained zero for 38 months after the implementation. There was a strong negative correlation between bundle compliance rate and CLABSI rates. With the implementation of the central-line bundle of care, together with emphasis on high compliance with all its components and a culture of patient safety, it was possible to achieve and maintain a zero rate of CLABSI in this ICU.

Ventral and incisional hernia: the cost of comorbidities and complications

“…CLABSI rate prior to introduction of care bundle at one hospital was reported to be 12.8/1000 catheter days. Over time, following implementation of the intervention and with judicious process evaluation and monitoring, the infection rate was reported as 0 for a 3-year time period [25]. The authors of the study mentioned that a ''culture of safety'' was related to their success with this program.…”

“…While the full extent of the financial burden of wound complications following VIHR is not in the scope of this study, quantifying the complete costs of wound complications is needed to define the comprehensive financial impact of VIHR to patients, hospitals, and society. Because of the high incidence, morbidity, and excess utilization of resources associated with central line-associated bloodstream infections (CLABSI), care bundles aimed at reducing the infection rate to near-zero have been introduced in health care systems [25,26]. CLABSI rate prior to introduction of care bundle at one hospital was reported to be 12.8/1000 catheter days.…”

“…as [19][20][21][22][23][24][25] % for open repairs [7,8]. Other reasons for unplanned 30-day readmission following VIHR are ileus or obstruction, bleeding, pulmonary issues, and venous thromboembolism (VTE) [1].…”

A proposal for a comprehensive approach to infections across the surgical pathway

“…Bundles can be defined as the systematic implementation of a set of evidence-based practices, usually three to five, that when performed properly and collectively can improve patient outcomes. Research on CRBSI prevention demonstrated the effectiveness of bundles, which reduce the incidence of CRBSI by up to 80% [35][36][37], reaching a rate of 0 in some cases [38]. Education and training of healthcare workers and adherence to standardized protocols for insertion and maintenance of intravascular catheters significantly reduced the incidence of catheter-related infections and represent the most important preventive measures.…”

Infection Control Bundles for the Prevention of Hospital Infections

“…Santral kateter ilişkili kan dolaşımı enfeksiyon insidansını, YBÜ'lerin kapasitesi, iş yükü, hastaların alt hastalıkları, mevcut hastalığın ağırlığı gibi faktörler belirlemektedir [27] . Ancak, yapılan çalışmalarda enfeksiyon kontrol demet uygulamaları ile SKİ-KDE hızının sıfıra indirilebileceği gösterilmiştir [28,29] .…”