The Impact of Implementation of Bundle to Reduce Catheter-Related Bloodstream Infection Rates.
BACKGROUND
The aim of the study was to investigate how control bundles reduce the rate of central venous catheter-associated bloodstream infections (CVC-BSIs) rates in critically ill patients.


METHODS
This is a prospective before-and-after study designed to evaluate whether a set of control measures (bundle) can help prevent CVC-BSI. The bundles included a checklist that aimed to correct practices related to CVC insertion, manipulation, and maintenance based on guidelines of the Center for Disease Control and Prevention (CDC).


RESULTS
We examined 123 checklists before and 155 checklists after implementation of the training program. Compared with the pre-intervention period, CVC-BSI rates decreased. Hand hygiene techniques were used correctly. CVC-BSI incidence was 9.3 and 5.1 per 1,000 catheter-days before and after the training program, respectively.


CONCLUSIONS
The implementation of a bundle and training program effectively reduces CVC-BSI rates.
Division of Intensive Care, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil ; Hospital Infection Control Committee, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil ; Ribeirao Preto Nursing School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Mayra Goncalves
MG
Menegueti
Getulio Vargas Foundation, Brazilian School of Economy and Finance, Rio de Janeiro, Brazil.
Kym Marcel Martins
KM
Ardison
Department of Social Medicine, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil ; Hospital Infection Control Committee, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Fernando
F
Bellissimo-Rodrigues
Hospital Infection Control Committee, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Gilberto Gambero
GG
Gaspar
Laboratorio Laboratory of Biomarkers, Rene Rachou Institute, Oswaldo Cruz Foundation, Belo Horizonte, Minas Gerais, Brazil.
Olindo Assis
OA
Martins-Filho
Division of Intensive Care, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Marcelo Lourencini
ML
Puga
Ribeirao Preto Nursing School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Ana Maria
AM
Laus
Division of Intensive Care, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Anibal
A
Basile-Filho
Division of Intensive Care, Department of Surgery and Anatomy, Ribeirao Preto Medical School, University of Sao Paulo, SP 14049-900 Ribeirao Preto, Brazil.
Maria
M
Auxiliadora-Martins
Catheter-related bloodstream infection; Central venous catheter; Educational intervention; Intensive care unit