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SG-APSIC1129: Long-term effect of a bundled care program in reducing central-line–associated bloodstream infections

Published online by Cambridge University Press:  16 March 2023

Yingchieh Liu
Affiliation:
National Taiwan University Hospital, Taiwan
Ying-Chieh Liu
Affiliation:
Taiwan, National Taiwan University Hospital, Taipei, Taiwan
Kuan-Yin Lin
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Chi-Tai Fang
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Yu-Jing Chang
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Sung-Ching Pan
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Jen-Tay Wang
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Wang-Huei Sheng
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Yee-Chun Chen
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Jia-Horng Kao
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan
Shan-Chwen Chang
Affiliation:
National Taiwan University Hospital, Taipei, Taiwan

Abstract

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Objectives: Central-line–associated bloodstream infection (CLABSI) has been the leading cause of healthcare-associated infections (HAIs) in the intensive care unit (ICU) setting. Previous studies have shown that a care bundle is effective in reducing CLABSI rates; however, the data on long-term sustainability and cost savings of bundled care are limited. Methods: From January 2011 to December 2020, a prospective surveillance was performed to monitor CLABSI at a university hospital in northern Taiwan. To reduce the CLABSI rate, a hospital-wide bundled care program for CLABSI prevention was implemented in 2013. We evaluated the long-term effect of the care bundle on CLABSI incidence and length of stay in the ICU. Results: During the study period, the overall CLABSI incidence decreased from 8.22 per 1,000 catheter days before the care bundle was implemented to 6.33 per 1,000 catheter days in 2020 (P for trend <.01). The most common pathogens causing CLABSI were gut organisms (1,420 of 2,363, 60.1%), followed by environmental organisms (734 of 2,363, 31.1%) and skin organisms (177 of 2,363, 7.5%). The decreasing trend was statistically significant in the incidence of CLABSI caused by skin organisms (P for trend < .01), but not in the incidence of CLABSI caused by environmental organisms (P for trend = .86) or gut organisms (P for trend = .06). In the multivariable analysis, implementation of this care bundle was independently associated with a decrease in the CLABSI rate (RR, 0.77; 95% CI, 0.66–0.88). Compared with patients without CLABSI, patients with CLABSI had a longer average ICU length of stay (27 vs 17 days). Conclusions: A sustainable reduction in the incidence of CLABSI caused by common commensals could be achieved through a cost-saving bundled care program.

Type
Healthcare-Associated Infection (HAI) Surveillance
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2023. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America