Skip to main content Accessibility help
×
Home

Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital

  • H. R. MARTÍNEZ-MOREL (a1) (a2), J. SANCHEZ-PAYÁ (a1), P. GARCÍA-SHIMIZU (a1), J. L. MENDOZA-GARCÍA (a1), I. TENZA-IGLESIAS (a1), J. C. RODRÍGUEZ-DÍAZ (a3), E. MERINO-DE-LUCAS (a4) and A. NOLASCO (a2)...

Summary

The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1–100%, P < 0·001) and maintenance (51·1–72·1%, P = 0·029) of CVCs; and the use of chlorhexidine for skin disinfection was implemented at insertion (35·7–65·4%, P < 0·001) and maintenance (33·3–45·9%, P < 0·197) of CVCs. There were 266 CR BSI incidents recorded with an annual incidence density of 5·75/1000 catheter-days in the first year, 4·38 in the second year [rate ratio (RR) 0·76, 95% confidence interval (CI) 0·57–1·01] and 3·46 in the third year (RR 0·60, 95% CI 0·44–0·81). The education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital
      Available formats
      ×

Copyright

Corresponding author

* Author for correspondence: Dr J. Sánchez-Payá, Unidad de Epidemiología, Servicio de Medicina Preventiva, Hospital General Universitario de Alicante, c/Pintor Baeza 12, 03010-Alicante, Spain. (Email: sanchez_jos@gva.es)

References

Hide All
1. Magill, SS, et al. Multistate point-prevalence survey of health care-associated infections. New England Journal of Medicine 2014; 370: 11981208.
2. Sánchez-Payá, J, et al. Nosocomial infection surveillance and control: current situation in Spanish hospitals. Journal of Hospital Infection 2009; 72: 5056.
3. International Nosocomial Infection Control Consortium Members. International Nosocomial Infection Control Consortium report, data summary for 2002–2007, issued January 2008. American Journal of Infection Control 2008; 36: 627637.
4. Wenzel, RP, Edmond, MB. Team-based prevention of catheter-related infections. New England Journal of Medicine 2006; 355: 27812783.
5. Suetens, C, et al. European surveillance of ICU-acquired infections (HELICS-ICU): methods and main results. Journal of Hospital Infection 2007; 65 (Suppl. 2): 171173.
6. Spanish Society of Preventive Medicine, Public Health and Hygiene-European Centre for Disease Prevention and Control. Evolution EPINE 1990-2014. Summary 2014 (http://hws.vhebron.net/epine/Descargas/EPINE%201990-20web.pdf). Accessed 21 March 2015.
7. Soufir, L, et al. Attributable morbidity and mortality of catheter-related septicemia in critically ill patients: a matched, risk-adjusted, cohort study. Infection Control and Hospital Epidemiology 1999; 20: 396401.
8. Tacconelli, E, et al. Epidemiology, medical outcomes and costs of catheter-related bloodstream infections in intensive care units of four European countries: literature- and registry-based estimates. Journal of Hospital Infection 2009; 72: 97103.
9. Saint, S, Veenstra, DL, Lipsky, BA. The clinical and economic consequences of nosocomial central venous catheter-related infection: are antimicrobial catheters useful? Infection Control and Hospital Epidemiology 2000; 21: 375380.
10. Cooper, K, et al. Are educational interventions to prevent catheter-related bloodstream infections in intensive care unit cost-effective? Journal of Hospital Infection 2014; 86: 4752.
11. O'Grady, NP, et al. Guidelines for the prevention of intravascular catheter-related infections. U.S. Centers for Disease Control and Prevention. Morbidity and Mortality Weekly Report 2002; 51: 129.
12. Marschall, J, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals. Infection Control and Hospital Epidemiology 2008; 29 (Suppl. 1): S2230.
13. Warren, DK, et al. Preventing catheter-associated bloodstream infections: a survey of policies for insertion and care of central venous catheters from hospitals in the prevention epicenter program. Infection Control and Hospital Epidemiology 2006; 27: 813.
14. GEIDI and ECCAUPE Study Groups. Guidelines for preventing catheter infection: assessment of knowledge and practice among paediatric and neonatal intensive care healthcare workers. Journal of Hospital Infection 2012; 81: 123127.
15. Aloul, B, et al. Medical residents self-reported adherence to guidelines during placement of central venous catheters. Infection Control and Hospital Epidemiology 2008; 9: 8688.
16. Van Herck, P, et al. Systematic review: effects, design choices, and context of pay-for-performance in health care. BMC Health Services Research 2010; 10: 247.
17. Lee, GM, et al. Effect of nonpayment for preventable infections in U.S. hospitals. New England Journal of Medicine 2012; 367: 14281437.
18. Pronovost, P, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. New England Journal of Medicine 2006; 355: 27252732.
19. Yoo, S, et al. Effectiveness of surveillance of central catheter-related bloodstream infection in an ICU in Korea. Infection Control and Hospital Epidemiology 2001; 22: 433436.
20. Pronovost, PJ, et al. Sustaining reductions in catheter related bloodstream infections in Michigan intensive care units: observational study. British Medical Journal 2010; 340: c309.
21. Trick, WE, et al. Prospective cohort study of central venous catheters among internal medicine ward patients. American Journal of Infection Control 2006; 34: 636641.
22. Trick, WE, et al. Unnecessary use of central venous catheters: the need to look outside the intensive care unit. Infection Control and Hospital Epidemiology 2004; 25: 266268.
23. Martínez-Morel, HR, et al. Catheter-related bloodstream infection: burden of disease in a tertiary hospital. Journal of Hospital Infection 2014; 87: 165170.
24. State-Based Healthcare-Associated Infection Prevention Public Health Advisors/Analysts. Enhancement of health department capacity for health care-associated infection prevention through Recovery Act-funded programs. American Journal of Public Health 2014; 104: e2733.
25. Ellingson, K, et al. Perspectives on federal funding for state health care-associated infection programs: achievements, barriers, and implications for sustainability. Medical Care Research and Review 2014; 71: 402415.
26. Ellingson, K, et al. Enhancement of health department capacity for health care-associated infection prevention through Recovery Act-funded programs. American Journal of Public Health 2014; 104: e2733.
27. Horan, TC, et al. CDC/NHSN surveillance definition of health care-associated infection and criteria for specific types of infections in the acute care setting. American Journal of Infection Control 2008; 36: 309332.
28. Safdar, N, et al. Meta-analysis: methods for diagnosing intravascular device-related bloodstream infection. Annals of Internal Medicine 2005; 15: 451466.
29. Flodgren, G, et al. Interventions to improve professional adherence to guidelines for prevention of device-related infections. Cochrane Database of Systematic Reviews 2013; 3: CD006559.
30. dos Santos, RP, et al. Changes in hand hygiene compliance after a multimodal intervention and seasonality variation. American Journal of Infection Control 2013; 41: 10121016.
31. Sax, H, et al. Determinants of good adherence to hand hygiene among healthcare workers who have extensive exposure to hand hygiene campaigns. Infection Control & Hospital Epidemiology 2007; 28: 12671274.

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed