Targeting prolonged short-term central venous catheters to reduce hospital-wide catheter days and CLABSI rates - 24/02/25
, Shelly Lipman-Arens, MD a, b, Lamis Mahamid, MD a, b, Linor Ishay, MD a, b, Olga Feld Simon, MD a, b, Sharon Reisfeld, MD a, b, Orna Ben-Natan, PhD, RN a, b, Aliza Vaknin, MN, RN a, b, Mohammed Ganayem, MA, RN a, b, Razi Abu Hadba, BA, RN c, Erez Karisi, MBA d, Noa Melnik, BSc d, Sarit Freimann, PhD e, †, Maanit Shapira, PhD b, e, Nina Avshovich, MD b, f, Ayed Darawshe, MA, RN f, Ronit Rachmilevitch, MD b, g, Valery Istomin, MD b, g, Rena Abilevitch, MA, RN g, Saif Abu-Mouch, MD b, h, Rotem Novoselsky, MA, RN h, Marinella Beckerman, MD b, i, Vlada Dubinchik, MA, RN i, Boris Kessel, MD b, j, Veacheslav Zilbermints, MD b, j, Veronika Starobinsky, MA, RN j, Inna Furman, MA, RN j, Konstantin Neimark, MD b, c, Yaakov Daskal, MD b, c, Mohanad Ganayem, MD b, c, Fanny Biton, MA, RN c, Boris Isakovich, MD b, c, Elias Tannous, MSc k, lRésumé |
Background |
The risk of central line-associated bloodstream infection (CLABSI) is associated with central venous catheter (CVC) dwelling time. We implemented a hospital-wide intervention aimed to alert physicians to CVC duration and necessity and to improve the monitoring of CLABSI prevention process measures outside the intensive care unit (ICU).
Methods |
A retrospective, before-after study that evaluated short-term, nonhemodialysis CVCs in and out of the ICU. The intervention included enhanced bundle-prevention measures monitoring and staff “sensitization” regarding prolonged (> 7 days) CVCs (pCVCs). The ICU intervention also included daily CVC-stewardship visits. We assessed CVC utilizations and CLABSI episodes 20 months before to 19 months after the intervention using Mann-Whitney tests.
Results |
Out of the ICU, CVC-utilization ratio (CVC-UR) and pCVC-UR reduced significantly (4.1-2.7/100 hospital days, P = .005; and 28%-21%, P = .02, respectively). Bundle-prevention measures improved, and CLABSI rates reduced postintervention (7.9-3.6/1,000 CVC days, P = .03). In the ICU, pCVC-UR reduced significantly (29%-15%, P < .0001). Baseline ICU-CLABSI rates were low and did not reduce postintervention.
Conclusions |
Sensitizing physicians to the existence and duration of CVCs accompanied by improved bundle-prevention measures, resulted in reduction of pCVCs, and outside the ICU, also in reduction of CVC-UR and CLABSI rates.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Data on CLABSI rates and prevention measures outside the intensive care unit are scarce. |
• | CLABSI risk is associated with central venous catheter (CVC) duration. |
• | Prolonged short-term CVCs may represent a target for CLABSI prevention. |
• | Sensitizing staff regarding CVC duration and necessity may reduce CVC utilization. |
• | Routine CVC replacement should be reconsidered. |
Key Words : Utilization ratio, Catheter related bloodstream infection, Catheter duration, Idle catheter, Bundle
Plan
| Conflicts of interest: None to report. |
Vol 53 - N° 3
P. 361-367 - mars 2025 Retour au numéro
Article précédent
- Role of admission rapid antigen testing (RATs) for COVID-19 on patients transferred from acute hospitals to a postacute rehabilitation setting
- Ann Gaffney, Edmond G. Smyth, Zena Moore, Declan Patton, Tom O' Connor, Rosemarie Derwin
- Estimating individual risk of catheter-associated urinary tract infections using explainable artificial intelligence on clinical data
- Herdiantri Sufriyana, Chieh Chen, Hua-Sheng Chiu, Pavel Sumazin, Po-Yu Yang, Jiunn-Horng Kang, Emily Chia-Yu Su
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?