Abstract:
Background: Central line-associated bloodstream infections (CLABSIs) pose a significant risk to critically ill patients, particularly in intensive care units (ICU) and are a significant cause of hospital-acquired infections. We investigated whether implementation of a multifaceted intervention was associated with reduced incidence of CLABSIs.
Methodology: This was a prospective cohort study over 9 years. We implemented a bundled intervention approach to prevent CLABSIs, consisting of a comprehensive unit-based safety program (CUSP). The program was implemented in the Neonatal ICU (NICU), Medical ICU (MICU) and Surgical ICU (SICU) departments at the Aga Khan University Hospital in Pakistan.
Results: The three intervention ICUs combined were associated with an overall 36% reduction in CLABSI rates and a sustained reduction in CLABSI rates for > a year (5 quarters). The NICU experienced a decrease of 77% in CLABSI rates lasting ~1 year (4 quarters). An attendance rate above 88% across all stake-holder groups in each CUSP meeting correlated with a better and more sustained infection reduction.
Conclusion: Our multi-faceted approach using the CUSP model was associated with reduced CLABSI-associated morbidity and mortality in resource limited settings. Our findings suggest that higher attendance rate (>80%) at meetings may be necessary to achieve sustained effects post-intervention.
Reference:Latif A, Ali W, Haleem S, Mahmood F, Munir T, Virani N, Khan H, Qadir M, Roshan R, Hooda K, Khan NM, Zafar A, Pronovost P. Implementation and Long-term Efficacy of a Multifaceted Intervention to Reduce Central Line-Associated Bloodstream Infections in Intensive Care Units of a Low Middle-Income Country. Am J Infect Control. 2024 Feb 7:S0196-6553(24)00060-9. doi: 10.1016/j.ajic.2024.02.001. Epub ahead of print. PMID: 38336128.