Implementation of an insertion bundle for preventing central line-associated bloodstream infections

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#IVTEAM #Intravenous literature: Osorio, J., Alvarez, D., Pacheco, R., Gómez, C.A. and Lozano, A. (2013) . Revista Chilena de Infectología. 230(5), p.465-73.

Abstract :

Central line-associated bloodstream infections (CLABSI) related to insertion and device care in intensive care units are frequent and preventable events.

Aim: To evaluate the reduction in the rate of CLABSI through implementation of an insertion bundle.

Methods: A study was conducted in the Adult-ICU at the University Hospital of Neiva comparing a pre-interventional period with an interventional one, each lasting 6 months; the intervention consisting of implementing a bundle of measures for the insertion of central venous catheters (CVC). In the pre-intervention period (2010) the rate of CLABSI and the population’s characteristics were evaluated. The bundle for the insertion of the CVC consisted in: hands hygiene, use of 2% clorhexidine, maximum sterile barriers and avoiding femoral access.

Results: The rate of CLABSI decreased from 5.56 to 3.26 per 1000 catheter days. The length of ICU stay and catheter duration were associated with a higher risk of infection associated to these devices (p < 0.05). Compliance with the bundle is a protective factor against the development of CLABSI (OR 0.45, p = 0.615). The staff adherence to the bundle was over 80%.

Conclusion: Implementing a Central Line Insertion Bundle proved to be a useful measure in prevention of CLABSI in our hospital. This strategy could be implemented in other hospitals of similar complexity.

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