title: Impact of an educational program for the prevention of colonization of intravascular catheters.
abstract: OBJECTIVE
  To evaluate the efficacy of an educational program for the prevention of catheter colonization.
  
  
  METHODS
  Two cross-sectional studies were carried out in a 500-bed randomly selected area of the hospital, separated by an educational program on the care of intravenous lines based on the Centers for Disease Control and Prevention (CDC) recommendations for the control of catheter-related infections.
  
  
  METHODS
  A 2,100-bed urban general hospital affiliated with the University of Madrid (Spain).
  
  
  METHODS
  Characteristics of patients and catheters and appropriateness of catheter care were evaluated. Cultures were taken from the point of insertion of the vascular catheter, the hubs, and infusion fluids. When catheter-associated infection was suspected, the distal end of the catheter was sent for culture and two blood cultures were taken. We compared the clinical and microbiological data before and after carrying out an educational program based on CDC recommendations for the control of catheter-related infections.
  
  
  RESULTS
  Characteristics of patients and catheters did not differ between the two cross-sectional studies. Compared with baseline data, after the educational program we observed a reduction of inappropriate catheter care, from 83% to 38% (45% difference, 95% confidence interval [CI95], 55% to 35%, P < 0.0000), and a reduction in the rate of skin colonization, from 34% to 18% (16% difference, CI95, 26% to 5%, P < 0.001). The frequency of phlebitis (15% versus 14%), hub colonizations (12% versus 11%), catheter colonizations (2% versus 1%), and catheter-related bacteremias (0% versus 0%) remained unchanged between the two cross-sectional studies.
  
  
  CONCLUSIONS
  Our educational program improved catheter care and reduced significantly the proportion of skin colonization around the insertion point. However, the educational program did not modify the proportion of hub colonization; because hub colonization has been demonstrated to be a source of line sepsis, our data suggest the need for a specific program directed to the maintenance of catheter hubs.
authors.affiliation: Department of Clinical Microbiology and Infectious Diseases, Hospital Gregorio Marañón, Madrid, Spain.
authors.forename: F
authors.initials: F
authors.lastname: Parras
authors.forename: J
authors.initials: J
authors.lastname: Ena
authors.forename: E
authors.initials: E
authors.lastname: Bouza
authors.forename: M C
authors.initials: MC
authors.lastname: Guerrero
authors.forename: S
authors.initials: S
authors.lastname: Moreno
authors.forename: T
authors.initials: T
authors.lastname: Gálvez
authors.forename: E
authors.initials: E
authors.lastname: Cercenado
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002405:Catheterization, Central Venous / Q000295:instrumentation*; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D002408:Catheters, Indwelling; D002487:Centers for Disease Control and Prevention, U.S.; D003430:Cross-Sectional Studies; D004866:Equipment Contamination; D005260:Female; D006282:Health Personnel / Q000193:education*; D006785:Hospitals, University; D006801:Humans; D017053:Infection Control; D007318:Inservice Training; D008297:Male; D008875:Middle Aged; D015397:Program Evaluation; D013030:Spain / Q000453:epidemiology; D014481:United States