Staphylococcus infection
Photo by Bill Branson
A central catheter maintenance bundle can decrease the incidence of central line-associated bloodstream infections (CLABSIs), according to a study published in the American Journal of Critical Care.
A team from the healthcare company Select Medical developed and implemented the bundle at 30 long-term acute care hospitals.
The team used infection prevention guidelines from the Centers for Disease Control and Prevention as the core of the bundle, with mandatory use of alcohol-based central catheter caps and chlorhexidine gluconate dressings.
Ongoing education of clinical staff about the protocol and a checklist to track compliance were also key elements of the initiative.
At each hospital, staff nurses who demonstrated competency in the care of central catheters monitored implementation of the bundle for the initial 6 months of the study.
Researchers reviewed the medical records of 6660 patients discharged during the 14 months prior to the study and 6559 patients discharged after implementation of the bundle. Patient days and central catheter days before and after the bundle was implemented were comparable.
Six months after the bundle was implemented, the CLABSI standardized infection rate had dropped 29%. The rate was 1.28 in the 6 months before the bundle was implemented and 0.96 six months after implementation.
There was a mean reduction of 4.5 CLABSIs per hospital for 14 months after the bundle was implemented.
“Our results encourage the development and implementation of similar bundles as effective infection reduction strategies in [long-term acute care hospitals],” said study author Antony Grigonis, PhD, vice-president of quality and healthcare analytics at Select Medical.
“Preventing these infections can help reduce complications and the length of stay for other patients. This infection reduction could also translate to a savings of approximately $3.7 million annually for the 30 long-term acute care hospitals studied.”
Select Medical, which is based in Mechanicsburg, Pennsylvania, owns long-term acute care and inpatient rehabilitation hospitals, as well as occupational health and physical therapy clinics.
