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The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections

Background: Catheter-related bloodstream infection (CRBSI) rates remain high despite the use of an insertion bundle. We hypothesized that line care and maintenance by a dedicated team would help decrease CRBSI rates. This study was conducted in The Medical City (TMC), is a 526-bed, private, tertiary...

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Autores principales: Charles Fil de Lara, Fortune, Mano, Maria Jesusa, Henson, Karl Evans, Bello, Jia An, Abad, Cybele Lara
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9614831/
http://dx.doi.org/10.1017/ash.2022.114
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author Charles Fil de Lara, Fortune
Mano, Maria Jesusa
Henson, Karl Evans
Bello, Jia An
Abad, Cybele Lara
author_facet Charles Fil de Lara, Fortune
Mano, Maria Jesusa
Henson, Karl Evans
Bello, Jia An
Abad, Cybele Lara
author_sort Charles Fil de Lara, Fortune
collection PubMed
description Background: Catheter-related bloodstream infection (CRBSI) rates remain high despite the use of an insertion bundle. We hypothesized that line care and maintenance by a dedicated team would help decrease CRBSI rates. This study was conducted in The Medical City (TMC), is a 526-bed, private, tertiary-care center in Pasig City, Philippines. Methods: All adult hospitalized patients from October 1, 2020, to October 31, 2021, with a newly inserted temporary central venous catheter (CVC) were eligible for inclusion. CRBSI rates before the intervention (October 2019 to March 2020) and after the intervention (April to October 2021) were compared. The intervention arm consisted of a dedicated central venous access team (CVAT) who provided education and performed daily line care and dressing changes per protocol. A series of χ(2) and Wilcoxon rank-sum tests were performed to compare characteristics between exposure groups. Incidence rates of CRBSI before and after the intervention were compared using an incidence rate ratio approach. Results: In total, 209 CVCs were enrolled in the study, with 103 CVCs (49.28%) in the preintervention arm and 106 CVCs (50.72%) in the postintervention arm. Baseline patient characteristics were similar. CRBSIs were more frequent in the preintervention arm than the postintervention arm (39 of 103 vs 28 of 106; P = .08). The CRBSI incidence density rate was higher in the preintervention arm than the postintervention arm, but the difference was not statistically significant (37.46 per 1,000 patient days vs 25.97 per 1,000 patient days; P = .14). Median time to CRBSI was similar in both groups (9 vs 8 days). Conclusions: Baseline CRBSI rates were high and risk of infection increased by day 8 after line insertion. We detected a decreasing trend in rates of CRBSI with a dedicated CVAT, but multiple interventions are likely needed to influence overall rates. Funding: None Disclosures: None
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spelling pubmed-96148312022-10-29 The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections Charles Fil de Lara, Fortune Mano, Maria Jesusa Henson, Karl Evans Bello, Jia An Abad, Cybele Lara Antimicrob Steward Healthc Epidemiol Clabsi Background: Catheter-related bloodstream infection (CRBSI) rates remain high despite the use of an insertion bundle. We hypothesized that line care and maintenance by a dedicated team would help decrease CRBSI rates. This study was conducted in The Medical City (TMC), is a 526-bed, private, tertiary-care center in Pasig City, Philippines. Methods: All adult hospitalized patients from October 1, 2020, to October 31, 2021, with a newly inserted temporary central venous catheter (CVC) were eligible for inclusion. CRBSI rates before the intervention (October 2019 to March 2020) and after the intervention (April to October 2021) were compared. The intervention arm consisted of a dedicated central venous access team (CVAT) who provided education and performed daily line care and dressing changes per protocol. A series of χ(2) and Wilcoxon rank-sum tests were performed to compare characteristics between exposure groups. Incidence rates of CRBSI before and after the intervention were compared using an incidence rate ratio approach. Results: In total, 209 CVCs were enrolled in the study, with 103 CVCs (49.28%) in the preintervention arm and 106 CVCs (50.72%) in the postintervention arm. Baseline patient characteristics were similar. CRBSIs were more frequent in the preintervention arm than the postintervention arm (39 of 103 vs 28 of 106; P = .08). The CRBSI incidence density rate was higher in the preintervention arm than the postintervention arm, but the difference was not statistically significant (37.46 per 1,000 patient days vs 25.97 per 1,000 patient days; P = .14). Median time to CRBSI was similar in both groups (9 vs 8 days). Conclusions: Baseline CRBSI rates were high and risk of infection increased by day 8 after line insertion. We detected a decreasing trend in rates of CRBSI with a dedicated CVAT, but multiple interventions are likely needed to influence overall rates. Funding: None Disclosures: None Cambridge University Press 2022-05-16 /pmc/articles/PMC9614831/ http://dx.doi.org/10.1017/ash.2022.114 Text en © The Society for Healthcare Epidemiology of America 2022 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clabsi
Charles Fil de Lara, Fortune
Mano, Maria Jesusa
Henson, Karl Evans
Bello, Jia An
Abad, Cybele Lara
The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
title The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
title_full The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
title_fullStr The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
title_full_unstemmed The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
title_short The effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
title_sort effectiveness of a dedicated central venous access care team to prevent catheter-related bloodstream infections
topic Clabsi
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9614831/
http://dx.doi.org/10.1017/ash.2022.114
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