Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections

Luisa Munoz-Price, Cameron Dezfulian, Mary Wyckoff, Joshua D Lenchus, Mara Rosalsky, David Birnbach, Kristopher Arheart

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Objective: Determine the impact of three stepwise interventions on the rate of central catheter-associated bloodstream infections. Design: Quasi-experimental study. Setting: Three surgical intensive care units (general surgery, trauma, and neurosurgery) at a 1500-bed county teaching hospital in the Miami metro area. Patients: All consecutive central catheter-associated bloodstream infection cases as determined by the Infection Control Department. INTERVENTIONS:: Three interventions aimed at catheter maintenance were implemented at different times in the units: chlorhexidine "scrub-the-hub, " chlorhexidine daily baths, and daily nursing rounds aimed at assuring compliance with an intensive care unit goal-oriented checklist. Measurements and Main Results: The primary outcome was the monthly intensive care unit rate of central catheter-associated bloodstream infections (infections per 1000 central catheter days). Over 33 months of follow-up (July 2008 to March 2011), we found decreased rates in each of the three intensive care units evaluated during the interventions, especially after implementation of chlorhexidine daily baths. Rates in unit A decreased from a rate of 8.6 to 0.5, unit B from 6.9 to 1.6, and unit C from 7.8 to 0.6. Secondary bloodstream infection rates remained unchanged throughout the observation period in units A and B; however, unit C had a decrease in its rates over time. Conclusions: We report the progressive reduction of central catheter-associated bloodstream infection rates after the stepwise implementation of chlorhexidine "scrub-the-hub" and daily baths in surgical intensive care units, suggesting effectiveness of these interventions.

Original languageEnglish
Pages (from-to)1464-1469
Number of pages6
JournalCritical Care Medicine
Volume40
Issue number5
DOIs
StatePublished - May 1 2012

Fingerprint

Catheter-Related Infections
Chlorhexidine
Intensive Care Units
Baths
Critical Care
Catheters
County Hospitals
Neurosurgery
Infection Control
Checklist
Coinfection
Teaching Hospitals
Nursing
Maintenance
Observation
Wounds and Injuries
Infection

Keywords

  • Central catheter-associated bloodstream infections
  • chlorhexidine
  • intensive care units

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

Cite this

Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections. / Munoz-Price, Luisa; Dezfulian, Cameron; Wyckoff, Mary; Lenchus, Joshua D; Rosalsky, Mara; Birnbach, David; Arheart, Kristopher.

In: Critical Care Medicine, Vol. 40, No. 5, 01.05.2012, p. 1464-1469.

Research output: Contribution to journalArticle

Munoz-Price, Luisa ; Dezfulian, Cameron ; Wyckoff, Mary ; Lenchus, Joshua D ; Rosalsky, Mara ; Birnbach, David ; Arheart, Kristopher. / Effectiveness of stepwise interventions targeted to decrease central catheter-associated bloodstream infections. In: Critical Care Medicine. 2012 ; Vol. 40, No. 5. pp. 1464-1469.
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