title: Effect of central line bundle on central line-associated bloodstream infections in intensive care units.
abstract: BACKGROUND
  This study was conducted in 4 intensive care units (ICUs) to investigate the effect of the central line (CL) bundle on central line-associated bloodstream infection (CLABSI).
  
  
  METHODS
  During phase 1 (baseline, from April 2009 to March 2010), active surveillance and training on hand hygiene only were conducted. During phase 2 (intervention, from April 2010 to December 2011), systemic training on the CL bundle and active surveillance and feedback with an electronic CL insertion checklist were performed.
  
  
  RESULTS
  Adherence to the CL bundle significantly increased from 0.0% in phase 1 to 37.1% in phase 2 (P < .001), but the change of CLABSI rate was insignificant for adults in ICUs. However, adherence to the CL bundle significantly increased from 0.8% in phase 1 to 20.1% in phase 2 (P < .001), and the CLABSI rate significantly decreased from 3.7 to 0.0 per 1,000 catheter-days (P = .014) for children in ICUs.
  
  
  CONCLUSIONS
  The higher adherence to the CL bundle was not positively correlated to a reduction in the CLABSI rate in adults, but it was related to a zero CLABSI for 18 months among children in the ICUs.
authors: College of Nursing, Pusan National University, Yangsan, Republic of Korea. jeongis@pusan.ac.kr
authors: Ihn Sook
authors: IS
authors: Jeong
authors: Soon Mi
authors: SM
authors: Park
authors: Jeon Ma
authors: JM
authors: Lee
authors: Ju Yeon
authors: JY
authors: Song
authors: Su Jin
authors: SJ
authors: Lee
mesh_terms: D000368:Aged; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage; D016470:Bacteremia / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects; D062905:Central Venous Catheters; D002675:Child, Preschool; D002710:Chlorhexidine / Q000008:administration & dosage; D003422:Critical Care / Q000379:methods / Q000592:standards; D005260:Female; D019983:Guideline Adherence; D063373:Hand Hygiene; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D017053:Infection Control / Q000379:methods*; D007362:Intensive Care Units / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged
chemical_list: D000891:Anti-Infective Agents, Local; D002710:Chlorhexidine
keywords: Barrier precaution; Central venous catheter; Chlorhexidine antisepsis; Hand hygiene; Sepsis