• Am J Infect Control · Jul 2014

    Sustained reduction of central line-associated bloodstream infections outside the intensive care unit with a multimodal intervention focusing on central line maintenance.

    • Ghinwa Dumyati, Cathleen Concannon, Edwin van Wijngaarden, Tanzy M T Love, Paul Graman, Ann Marie Pettis, Linda Greene, Nayef El-Daher, Donna Farnsworth, Gail Quinlan, Gloria Karr, Lynnette Ward, Robin Knab, and Mark Shelly.
    • Department of Medicine, Infectious Diseases Division, University of Rochester Medical Center, Rochester, NY; Center for Community Health, University of Rochester Medical Center, Rochester, NY. Electronic address: Ghinwa_dumyati@urmc.rochester.edu.
    • Am J Infect Control. 2014 Jul 1; 42 (7): 723-30.

    BackgroundCentral venous catheter use is common outside the intensive care units (ICUs), but prevention in this setting is not well studied. We initiated surveillance for central line-associated bloodstream infections (CLABSIs) outside the ICU setting and studied the impact of a multimodal intervention on the incidence of CLABSIs across multiple hospitals.MethodsThis project was constructed as a prospective preintervention-postintervention design. The project comprised 3 phases (preintervention [baseline], intervention, and postintervention) over a 4.5-year period (2008-2012) and was implemented through a collaborative of 37 adult non-ICU wards at 6 hospitals in the Rochester, NY area. The intervention focused on engagement of nursing staff and leadership, nursing education on line care maintenance, competence evaluation, audits of line care, and regular feedback on CLABSI rates. Quarterly rates were compared over time in relation to intervention implementation.ResultsThe overall CLABSI rate for all participating units decreased from 2.6/1000 line-days preintervention to 2.1/1,000 line-days during the intervention and to 1.3/1,000 line-days postintervention, a 50% reduction (95% confidence interval, .40-.59) compared with the preintervention period (P .0179).ConclusionA multipronged approach blending both the adaptive and technical aspects of care including front line engagement, education, execution of best practices, and evaluation of both process and outcome measures may provide an effective strategy for reducing CLABSI rates outside the ICU.Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

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