Catheter-related bloodstream infection reduction using systematic training in a Portuguese tertiary care hospital.

Abstract

Catheter-related bloodstream infections (CRBSI) are a major cause of morbidity, mortality, and increased healthcare costs among hospital-acquired infections. To reduce CRBSI, the Infection Prevention and Control and Antimicrobial Resistance Program (UL-PPCIRA) reviewed current guidelines and implemented an intensive training project for healthcare professionals. Following the publication of care bundles, cascade training was conducted for staff involved in central line insertion and maintenance. This study aimed to evaluate the impact of this continuous quality improvement project on CRBSI incidence in a tertiary hospital. Three consecutive periods of 2 years were analyzed: two before and one after implementation. CRBSI rates were 1.84, 1.68, and 0.65 per 1000 catheter-days in periods 1, 2, and 3, respectively. No significant difference was observed between periods 1 and 2 (IRR 0.92, 95% CI 0.52-1.63). In contrast, period 3 showed a significant reduction compared to period 2 (IRR 0.35, 95% CI 0.14-0.78; p = .02). The implementation of standardized care bundles, supported by structured training, was associated with a significant reduction in CRBSI. Ongoing monitoring and reinforcement strategies are essential to ensure long-term sustainability.