Patient empowerment and CLABSI reduction
Abstract:
Background: Patients with hematologic malignancies and hematopoietic stem cell transplant recipients (HSCT) are at high risk of central venous catheter-related bloodstream infections (CLABSI). Global actions have encouraged patient training and empowerment as a strategy to reduce these infections.
Objective: To evaluate the impact of patient empowerment in reducing the incidence density (ID) of CLABSI.
Methods: Prospective, pre- and post-intervention, quantitative study of development, validation and application of an instrument to assess good practices in CVC handling, consisting of six questions and answers by hospitalized patients who had a CVC in two units of an oncological hospital.
Results: Fifty-three patients participated in the study, totaling 1290 evaluations. In the post-intervention period, a significant increase (p<0.001) was observed in three practices: hand hygiene after handling the CVC (92.1% vs. 98.8%), salinization with pulsatile movements after administering medications and collecting laboratory tests (86.8% vs. 96.7%) and daily CVC assessment (97.4% vs. 99.8%). The ID of CLABSI decreased in the HSCT unit (4.4 vs. 0 CLABSI/1,000 CVC-days), though without statistical significance (p=0.066).
Discussion: Increased adherence to good practices highlights the potential of patient involvement as a complementary strategy for CLABSI prevention.
Conclusion: Actions aimed at patient participation can contribute to improving processes and reducing the ID of CLABSI.
Reference:
Reghini R, França E Silva ILA, Costa SF, Guimarães T. Impact of empowerment of onco-hematological patients on the incidence of catheter-related bloodstream infections. Am J Infect Control. 2025 Jun 22:S0196-6553(25)00433-X. doi: 10.1016/j.ajic.2025.06.015. Epub ahead of print. PMID: 40555296.