Catheter-related bloodstream infection: burden of disease in a tertiary hospital


Autoria(s): Martínez-Morel, H.R.; Sánchez-Payá, J.; Molina-Gómez, M.J.; García-Shimizu, P.; García Román, V.; Villanueva-Ruiz, C.; González-Hernández, M.; Nolasco, Andreu
Contribuinte(s)

Universidad de Alicante. Departamento de Enfermería Comunitaria, Medicina Preventiva y Salud Pública e Historia de la Ciencia

Grupo Balmis de Investigación en Salud Comunitaria e Historia de la Ciencia

Data(s)

02/02/2015

02/02/2015

01/07/2014

Resumo

Background: Surveillance programmes have become the most effective tool for controlling catheter-related bloodstream infections (CRBSI). However, few studies have investigated programmes covering all hospital settings. Aim: To describe the results of a control and prevention programme for CRBSI based on compliance with recommendations for insertion and maintenance, using annual burden of disease in a tertiary level hospital. Methods: A CRBSI control and prevention programme involving all hospital settings was implemented. The programme consisted of CRBSI surveillance, direct observation of insertion and maintenance of catheters to determine performance, and education for healthcare workers. Findings: In total, 2043 short-term catheters were inserted in 1546 patients for 18,570 catheter-days, and 279 long-term catheters were inserted in 243 patients for 40,440 catheter-days. The annual incidence density was 5.98 (first semester 6.40, second semester 5.64) CRBSI per 1000 catheter-days for short-term catheters, and 0.57 (first semester 0.66, second semester 0.43) CRBSI per 1000 catheter-days for long-term catheters. One hundred and forty insertion procedures were observed, with an average insertion time of 13 (standard deviation 7) min. Compliance with recommendations was as follows: hand hygiene, 86.8%; use of alcoholic chlorhexidine solution for skin disinfection, 35.5%; use of mask, 93.4%; use of gloves, 98.7%; use of gown, 75.0%; use of sterile cloth, 93.8%; use of cap, 92.2%; bandage application, 62.7%; and use of aseptic technique, 89.5%. Forty-five maintenance procedures were observed, and compliance rates were as follows: hand hygiene, 42.1%; use of gloves, 78.1%; and port disinfection with alcoholic chlorhexidine solution, 32.5%. Conclusion: The CRBSI control and prevention programme implemented at the study hospital has decreased the rate of CRBSI, provided important information about the total burden of disease, and revealed possible ways to improve interventions in the future.

The programme was supported by the Carlos III Health Institute, Ministry of Science and Innovation of Spain (Grant Number: PI080881). Additional support was provided by the Foundation for Research of the General University Hospital of Alicante, Spain (Grant Number: PC-06/2009).

Identificador

Journal of Hospital Infection. 2014, 87(3): 165-170. doi:10.1016/j.jhin.2014.04.008

0195-6701

http://hdl.handle.net/10045/44478

10.1016/j.jhin.2014.04.008

Idioma(s)

eng

Publicador

Elsevier

Relação

http://dx.doi.org/10.1016/j.jhin.2014.04.008

Direitos

© 2014 The Healthcare Infection Society. Published by Elsevier Ltd.

info:eu-repo/semantics/restrictedAccess

Palavras-Chave #Catheter-related bloodstream infection #Central venous catheter #Primary bloodstream infection #Surveillance #Infection control #Enfermería
Tipo

info:eu-repo/semantics/article