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Title: Impact of a program to prevent central line-associated bloodstream infection in the zero tolerance era
Authors: Marra, Alexandre R.
Rodrigues Cal, Ruy Guilherme
Durao, Marcelino Souza [UNIFESP]
Correa, Luci
Guastelli, Luciana Reis
Moura, Denis Faria
Edmond, Michael B.
Pavao dos Santos, Oscar Fernando [UNIFESP]
Hosp Israelita Albert Einstein
Universidade Federal de São Paulo (UNIFESP)
Virginia Commonwealth Univ
Keywords: Bloodstream infection
intensive care unit
step-down unit
zero tolerance
central venous catheter
central line bundle
Issue Date: 1-Aug-2010
Publisher: Elsevier B.V.
Citation: American Journal of Infection Control. New York: Mosby-Elsevier, v. 38, n. 6, p. 434-439, 2010.
Abstract: Background: Central line-associated bloodstream infection (CLABSI) is one of the most important health care-associated infections in the critical care setting.Methods: A quasiexperimental study involving multiple interventions to reduce the incidence of CLABSI was conducted in a medical-surgical intensive care unit (ICU) and in 2 step-down units (SDUs). From March 2005 to March 2007 (phase 1 [P1]), some Centers for Disease Control and Prevention evidence-based practices were implemented. From April 2007 to April 2009 (P2), we intervened in these processes at the same time that performance monitoring was occurring at the bedside, and we implemented the Institute for Healthcare Improvement central line bundle for all ICU and SDU patients requiring central venous lines.Results: the mean incidence density of CLABSI per 1000 catheter-days in the ICU was 6.4 in phase 1 and 3.2 in phase 2, P < .001. the mean incidence density of CLABSI per 1000 catheter-days in the SDUs was 4.1 in phase 1 and 1.6 in phase 2, P = 5.005.Conclusion: These results suggest that reducing CLABSI rates in an ICU setting is a complex process that involves multiple performance measures and interventions that can also be applied to SDU settings.
ISSN: 0196-6553
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