Faculty of Medicine
Library of the School of Health Sciences

2020-06-30

2020

Karapanou Amalia

Γεώργιος Λ. Δαΐκος, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Ελένη Ι. Γκόγκα, Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ
Νικόλαος Σύψας, Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Χρυσούλα Λεμονίδου, Καθηγήτρια, Τμήμα Νοσηλευτικής, ΕΚΠΑ
Μιχαήλ Σαμάρκος, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ, Επιβλέπων
Δημήτριος Μαντάς, Αναπληρωτής Καθηγητής, Ιατρική Σχολή, ΕΚΠΑ
Μίνα Ψυχογυιού, Επίκουρη Καθηγήτρια, Ιατρική Σχολή, ΕΚΠΑ

Πρόληψη λοιμώξεων από κεντρικούς φλεβικούς καθετήρες με την εφαρμογή δέσμης μέτρων

Greek

Implementation of a modified CVC insertion and care bundle in a high bed occupancy hospital

Indroduction: The use of central venous catheters (CVCs) is an integral part of modern health care throughout the world, allowing for the administration of intravenous fluids, blood products, medications, and parenteral nutrition, as well as providing access for hemodialysis and hemodynamic monitoring. However, their use is associated with the risk of bloodstream infection caused by microorganisms that colonize the external surface of the device or the fluid pathway when the device is inserted or manipulated after insertion. These serious infections, termed central line–associated bloodstream infections, or CLABSIs, are associated with increased morbidity, mortality, and health care costs. It is now recognized that CLABSIs are largely preventable when evidence- based guidelines are followed for the insertion and maintenance of CVCs.
Aim of the study: The main purpose of the present study is to record the incidence of CLABSI and evaluate the efficacy of bundles in order to reduce these infections.
Methods: This is a prospective study, with repeating measuremnts (Before-After intervention). The study was carried out in all nursing departments of the Laiko General Hospital (ICU and clinical departments). For technical reasons, the Emergency Department, was excluded from this study. Three types of data were collected: a) Data relating to the reference population (Patient-days, Catheters- days), b) CLABSI frequency data (Installation of a CLABSI surveillance system) and c) Compliance data with the proposed measures (Evaluation of CVC insertion and care practices, through a checklist).
Results: We have studied 913 CVC insertions (454 in PRE and 459 in POST) for 11,871 catheter- days. The incidence of CLABSI was 8.3 per 1,000 catheter-days PRE, and 7.6 per 1,000 catheter- days POST (incidence rate ratio, 0.92; 95% confidence interval, 0.60-1.40). Compliance with the CVC insertion bundle increased from 8.4%-74.3% (P < .0001). The CVC management bundle compliance also increased from 11.4%-57.7% (P < .0001).
Conclusions: Despite improved compliance after the intervention, implementation of a modified CVC bundle failed to decrease CLABSI incidence. Higher bundle compliance rates may be necessary for a significant decrease in the incidence of CLABSI, along with the appropriate organizational culture and levels of staffing.

Health Sciences

Bundle, CVC

Yes

4

Yes

256

167

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https://pergamos.lib.uoa.gr/uoa/dl/object/2917686