title: [Results of a multidisciplinary and multifocal project to reduce bacteraemia caused by central venous catheters in non critical patients in a university hospital].
abstract: OBJECTIVE
  To evaluate a multidisciplinary and multifocal intervention in order to reduce catheter related bloodstream infections (CRBI), based on previously identified risk factors in non-critical patients.
  
  
  METHODS
  A pre-post-intervention study, 2004-2006.
  
  
  METHODS
  patients with a central venous catheter (CVC). The primary endpoint was the CRBI. Other studied variables were patient characteristics, insertion, maintenance and removal of the catheter. The intervention consisted of baseline knowledge and identifying risk factors. In a second period, there was specific training on these identified risk factors and communication of the results, monitoring and evaluation of the CVC inserted.
  
  
  RESULTS
  We analysed 175 and 200 CVC, respectively. The incidence of CRBI was 15.4% during the pre-intervention and 4.0% in the post-intervention period (P<.001). The incidence of BRC by CVC days in the first group was 8.8 infections 1.000 days of CVC and the second 2,3 (P=.0009). The multivariate analysis found an increased risk of CRBI during the first period (OR 4.32; 95% CI: 1.81-10.29) and the use of total parenteral nutrition (OR: 2.37; 95% CI: 1.10-5. 12).
  
  
  CONCLUSIONS
  The application of specific measures directed at all non-critical patients in the entire hospital and involving a large number of professionals has achieved a decrease incidence of 73.9% of CRBI. An acceptable incidence of CRBI was obtained, and, with the completion of the project together with a new awareness, the situation will continue to improve.
authors.affiliation: Servei d'Avaluació i Epidemiologia Clínica-SAEC, Hospital del Mar Consorci Mar Parc de Salut, Departament de Medicina, UAB, Barcelona, España. Mterradas@hospitaldelmar.cat
authors.forename: Roser
authors.initials: R
authors.lastname: Terradas
authors.forename: Marta
authors.initials: M
authors.lastname: Riu
authors.forename: Marcel
authors.initials: M
authors.lastname: Segura
authors.forename: Xavier
authors.initials: X
authors.lastname: Castells
authors.forename: Mónica
authors.initials: M
authors.lastname: Lacambra
authors.forename: Juan Carlos
authors.initials: JC
authors.lastname: Alvarez
authors.forename: Agia
authors.initials: A
authors.lastname: Segura
authors.forename: Estela
authors.initials: E
authors.lastname: Membrilla
authors.forename: Luís
authors.initials: L
authors.lastname: Grande
authors.forename: Gemma
authors.initials: G
authors.lastname: Segura
authors.forename: Hernando
authors.initials: H
authors.lastname: Knobel
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016470:Bacteremia / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D010348:Patient Care Team; D012307:Risk Factors; D055815:Young Adult