Reduced central line-associated bloodstream infection by application of integrated evidence-based care bundle in critically ill patients

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  • Tao-Fen Shiung, BS; Shu-Fen Lu RN, MSN; Shin-shang Chou RN, MSN, MBA

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http://hdl.handle.net/10755/202150
Abstract

Central venous catheter-associated bloodstream infections (CBI) are frequent causes of morbidity and mortality in intensive care units (ICU). The purpose of this study is to apply an integrated evidence-based care bundle in critically ills for reducing CBI rate. The study was divided into in 2 phases F Phase I: Follow the evidence-based medicine approach, systematic literature review, critical appraisal and integrate the evidence, the central venous catheter (CVC) clinical guideline was formed; then the expert focus group study approach selected 5 items to form the CVC care bundle, which included hand hygiene, maximum sterile barrier precautions, CVC maintaining, daily inspection of the insertion site and reviewing of the need for CVC. Phase II: A pre-post experimental design study was conducted in a 42-bed medical-surgical ICU in a medical center. There were 74 patients in experimental group and 61 patients in control group. Study interventions include an education program for staffs and implement the care bundles into daily practice. The data collection included patients' demographic data, CBI risk assessment sheet, and checklist of nurses' compliance with CVC care bundles. The outcomes indicators were CBI incidence, length of stay in ICU and the compliance rate of nurses. The study results revealed that the experimental group had a lower rate of CBI (6/68 vs. 13/48, p<.05), less days in ICU (15.7 vs. 18.5, p<.05) and less catheter days (7.8 vs. 9.0, p<.05). The compliance rates of hand hygiene (94.6% vs. 50.8%), maximum sterile barrier precautions (98.6% vs. 4.9%), CVC maintaining (98.6% vs.54.1%), and daily inspection of the insertion site and reviewing of the need for CVC (98.0% vs. 68.9%) were all improved significantly. This study results provide a strong evidence for clinicians in preventing CBI rates by application CVC care bundles in critically ills.

Description

41st Biennial Convention: People and Knowledge: Connecting for Global Health

Repository Posting Date
2012-01-11T11:12:43Z
Notes

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Type Information
TypePresentation
AcquisitionProxy-submission
Review TypeAbstract Review Only: Reviewed by Event Host
FormatText-based Document
Category Information
Evidence LevelN/A
Research ApproachN/A
KeywordsCatheter-Related Blood Stream Infection;
Central Venous Catheter;
Care Bundle
Conference Information
Name41st Biennial Convention: People and Knowledge: Connecting for Global Health
HostSigma Theta Tau International
LocationGrapevine, Texas, USA
Date2011
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