title: Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital.
abstract: The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1-100%, P < 0·001) and maintenance (51·1-72·1%, P = 0·029) of CVCs; and the use of chlorhexidine for skin disinfection was implemented at insertion (35·7-65·4%, P < 0·001) and maintenance (33·3-45·9%, P < 0·197) of CVCs. There were 266 CR BSI incidents recorded with an annual incidence density of 5·75/1000 catheter-days in the first year, 4·38 in the second year [rate ratio (RR) 0·76, 95% confidence interval (CI) 0·57-1·01] and 3·46 in the third year (RR 0·60, 95% CI 0·44-0·81). The education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs.
authors.affiliation: Department of Preventive Medicine,Alicante University General Hospital,Alicante,Spain.
authors.forename: H R
authors.initials: HR
authors.lastname: Martínez-Morel
authors.affiliation: Department of Preventive Medicine,Alicante University General Hospital,Alicante,Spain.
authors.forename: J
authors.initials: J
authors.lastname: Sanchez-Payá
authors.affiliation: Department of Preventive Medicine,Alicante University General Hospital,Alicante,Spain.
authors.forename: P
authors.initials: P
authors.lastname: García-Shimizu
authors.affiliation: Department of Preventive Medicine,Alicante University General Hospital,Alicante,Spain.
authors.forename: J L
authors.initials: JL
authors.lastname: Mendoza-García
authors.affiliation: Department of Preventive Medicine,Alicante University General Hospital,Alicante,Spain.
authors.forename: I
authors.initials: I
authors.lastname: Tenza-Iglesias
authors.affiliation: Department of Microbiology,Alicante University General Hospital,Alicante,Spain.
authors.forename: J C
authors.initials: JC
authors.lastname: Rodríguez-Díaz
authors.affiliation: Infection Disease Unit,Alicante University General Hospital,Alicante,Spain.
authors.forename: E
authors.initials: E
authors.lastname: Merino-DE-Lucas
authors.affiliation: Department of Community Nursing,Preventive Medicine and Public Health and History of Science,Alicante University,Carretera de San Vicente del Raspeig,Alicante,Spain.
authors.forename: A
authors.initials: A
authors.lastname: Nolasco
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D055499:Catheter-Related Infections / Q000453:epidemiology* / Q000517:prevention & control*; D002404:Catheterization / Q000009:adverse effects; D062905:Central Venous Catheters / Q000009:adverse effects; D004203:Disinfection / Q000379:methods / Q000706:statistics & numerical data; D004501:Education, Medical; D005260:Female; D019983:Guideline Adherence; D006302:Health Services Research; D006801:Humans; D015994:Incidence; D017053:Infection Control / Q000379:methods*; D008297:Male; D008875:Middle Aged; D018805:Sepsis / Q000453:epidemiology* / Q000517:prevention & control*; D062606:Tertiary Care Centers
keywords: Catheter-related bloodstream infection; central venous catheter; prevention; programme evaluation