Universal Patient Disinfection as a Tool for Infection Control

Peterson, Lance R.; Singh, Kamalji T

doi:10.1001/archinte.166.3.274

Cited by 8 publications

(2 citation statements)

References 23 publications

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“…Based on our RCA, there were no other suggested associations between catheter variables (type, number of lumens, and material) and the risk for developing CLA‐BSIs. A reduction in the BMT CLA‐BSI rate was observed after cessation of power PICCs and implementation of CHG bathing 34, 36. However, a causal relationship can only be inferred by temporal association.…”

Section: Discussionmentioning

confidence: 99%

“…In July 2009 (14 months after the initial intervention), power peripherally inserted central catheters (PICC) were discontinued as a result of a suspected association with CLA‐BSIs. As part of ongoing Plan‐Do‐Study‐Act quality improvement work, daily chlorhexidine gluconate (CHG) cleansing 34–36 was also implemented in January 2010 (20 months after the initial intervention).…”

Section: Methodsmentioning

confidence: 99%

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Rapid reduction of central line infections in hospitalized pediatric oncology patients through simple quality improvement methods

Choi

Chang

Hanauer

et al. 2012

Pediatric Blood & Cancer

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Background Pediatric hematology-oncology (PHO) patients are at significant risk for developing central line-associated bloodstream infections (CLA-BSIs) due to their prolonged dependence on such catheters. Effective strategies to eliminate these preventable infections are urgently needed. In this study, we investigated the implementation of bundled central line maintenance practices and their effect on hospital-acquired CLA-BSIs. Materials and Methods CLA-BSI rates were analyzed within a single-institution’s PHO unit between January 2005 and June 2011. In May 2008, a multidisciplinary quality improvement team developed techniques to improve the PHO unit’s safety culture and implemented the use of catheter maintenance practices tailored to PHO patients. Data analysis was performed using time-series methods to evaluate the pre- and post-intervention effect of the practice changes. Results The pre-intervention CLA-BSI incidence was 2.92 per 1000-patient days (PD) and coagulase-negative Staphylococcus was the most prevalent pathogen (29%). In the post-intervention period, the CLA-BSI rate decreased substantially (45%) to 1.61 per 1000-PD (p<0.004). Early on, blood and marrow transplant (BMT) patients had a three-fold higher CLA-BSI rate compared to non-BMT patients (p<0.033). With additional infection control countermeasures added to the bundled practices, BMT patients experienced a larger CLA-BSI rate reduction such that BMT and non-BMT CLA-BSI rates were not significantly different post-intervention. Conclusions By adopting and effectively implementing uniform maintenance catheter care practices, learning multidisciplinary teamwork, and promoting a culture of patient safety, the CLA-BSI incidence in our study population was significantly reduced and maintained.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%