title: A survey of preventive measures used and their impact on central line-associated bloodstream infections (CLABSI) in intensive care units (SPIN-BACC).
abstract: BACKGROUND
  The Quebec central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) Surveillance Program saw a decrease in CLABSI rates in most ICUs. Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented, if compliance to measures was monitored and its impact on CLABSI incidence rates.
  
  
  METHODS
  All hospitals participating in the Quebec healthcare-associated infections surveillance program (SPIN-BACC - n = 48) received a 77-question survey about preventive measures implemented and monitored in their ICU. The questionnaire was validated for construct, content, face validity, and reliability. We used Poisson regression to measure the association between compliance monitoring to preventive measures and CLABSI rates.
  
  
  RESULTS
  Forty-two (88%) eligible hospitals completed the survey. Two components from the maximum barrier precautions were used less optimally: cap (88%) and full sterile body drape (71%). Preventive measures reported included daily review of catheter need (79%) and evaluation of insertion site for the presence of inflammation (90%). Two hospitals rewired lines even if an infection was suspected or documented.In adult ICUs, there was a statistically significant greater decrease in CLABSI rates in ICUs that monitored compliance to preventive insertion measures, after adjusting for teaching status and the number of hospital beds (p = 0.036).
  
  
  CONCLUSIONS
  Hospitals participating to the SPIN-BACC program follow recommendations for CLABSI prevention, but only a minority locally monitor their application. Compliance monitoring of preventive measures for catheter insertion was associated with a decrease in CLABSI incidence rates.
authors.affiliation: Department of Pediatrics, The Montreal Children's Hospital, McGill University, Quebec, Québec, Canada. caroline.quach@mcgill.ca.
authors.forename: Milagros
authors.initials: M
authors.lastname: Gonzales
authors.forename: Isabelle
authors.initials: I
authors.lastname: Rocher
authors.forename: Elise
authors.initials: E
authors.lastname: Fortin
authors.forename: Patricia
authors.initials: P
authors.lastname: Fontela
authors.forename: Mohammed
authors.initials: M
authors.lastname: Kaouache
authors.forename: Claude
authors.initials: C
authors.lastname: Tremblay
authors.forename: Charles
authors.initials: C
authors.lastname: Frenette
authors.forename: Caroline
authors.initials: C
authors.lastname: Quach
mesh_terms: D000328:Adult; D016470:Bacteremia / Q000453:epidemiology / Q000517:prevention & control; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000517:prevention & control; D003428:Cross Infection / Q000453:epidemiology* / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D004865:Equipment and Supplies, Hospital / Q000382:microbiology; D005260:Female; D006801:Humans; D017053:Infection Control; D007362:Intensive Care Units / Q000706:statistics & numerical data; D011792:Quebec; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires