{"title":"Targeting prolonged short-term central venous catheters to reduce hospital-wide catheter days and CLABSI rates","authors":"Regev Cohen MD , Shelly Lipman-Arens MD , Lamis Mahamid MD , Linor Ishay MD , Olga Feld Simon MD , Sharon Reisfeld MD , Orna Ben-Natan PhD, RN , Aliza Vaknin MN, RN , Mohammed Ganayem MA, RN , Razi Abu Hadba BA, RN , Erez Karisi MBA , Noa Melnik BSc , Sarit Freimann PhD , Maanit Shapira PhD , Nina Avshovich MD , Ayed Darawshe MA, RN , Ronit Rachmilevitch MD , Valery Istomin MD , Rena Abilevitch MA, RN , Saif Abu-Mouch MD , Elias Tannous MSc","doi":"10.1016/j.ajic.2024.10.011","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The risk of central line-associated bloodstream infection (CLABSI) is associated with central venous catheter (CVC) dwelling time. We implemented a hospital-wide intervention aimed to alert physicians to CVC duration and necessity and to improve the monitoring of CLABSI prevention process measures outside the intensive care unit (ICU).</div></div><div><h3>Methods</h3><div>A retrospective, before-after study that evaluated short-term, nonhemodialysis CVCs in and out of the ICU. The intervention included enhanced bundle-prevention measures monitoring and staff “sensitization” regarding prolonged (> 7 days) CVCs (pCVCs). The ICU intervention also included daily CVC-stewardship visits. We assessed CVC utilizations and CLABSI episodes 20 months before to 19 months after the intervention using Mann-Whitney tests.</div></div><div><h3>Results</h3><div>Out of the ICU, CVC-utilization ratio (CVC-UR) and pCVC-UR reduced significantly (4.1-2.7/100 hospital days, <em>P</em> = .005; and 28%-21%, <em>P</em> = .02, respectively). Bundle-prevention measures improved, and CLABSI rates reduced postintervention (7.9-3.6/1,000 CVC days, <em>P</em> = .03). In the ICU, pCVC-UR reduced significantly (29%-15%, <em>P</em> < .0001). Baseline ICU-CLABSI rates were low and did not reduce postintervention.</div></div><div><h3>Conclusions</h3><div>Sensitizing physicians to the existence and duration of CVCs accompanied by improved bundle-prevention measures, resulted in reduction of pCVCs, and outside the ICU, also in reduction of CVC-UR and CLABSI rates.</div></div>","PeriodicalId":7621,"journal":{"name":"American journal of infection control","volume":"53 3","pages":"Pages 361-367"},"PeriodicalIF":3.8000,"publicationDate":"2024-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of infection control","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0196655324007995","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0
Abstract
Background
The risk of central line-associated bloodstream infection (CLABSI) is associated with central venous catheter (CVC) dwelling time. We implemented a hospital-wide intervention aimed to alert physicians to CVC duration and necessity and to improve the monitoring of CLABSI prevention process measures outside the intensive care unit (ICU).
Methods
A retrospective, before-after study that evaluated short-term, nonhemodialysis CVCs in and out of the ICU. The intervention included enhanced bundle-prevention measures monitoring and staff “sensitization” regarding prolonged (> 7 days) CVCs (pCVCs). The ICU intervention also included daily CVC-stewardship visits. We assessed CVC utilizations and CLABSI episodes 20 months before to 19 months after the intervention using Mann-Whitney tests.
Results
Out of the ICU, CVC-utilization ratio (CVC-UR) and pCVC-UR reduced significantly (4.1-2.7/100 hospital days, P = .005; and 28%-21%, P = .02, respectively). Bundle-prevention measures improved, and CLABSI rates reduced postintervention (7.9-3.6/1,000 CVC days, P = .03). In the ICU, pCVC-UR reduced significantly (29%-15%, P < .0001). Baseline ICU-CLABSI rates were low and did not reduce postintervention.
Conclusions
Sensitizing physicians to the existence and duration of CVCs accompanied by improved bundle-prevention measures, resulted in reduction of pCVCs, and outside the ICU, also in reduction of CVC-UR and CLABSI rates.
期刊介绍:
AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)