PURPOSE: Catheter-related bloodstream infection (CRBSI) is the most frequently occurring nosocomial infection. The "2006 Institute of Health Improvement (IHI) bundle" is a set of interventions to assist hospitals in reducing the rate of CRBSI. This report highlights the impact of implementing the bundle in the reduction of the CLABSI rate in our Spinal Cord Injury Center (SCI). The IHI bundle was implemented at the SCI center in late 2006.
METHODS: We performed a retrospective chart review of 895 patients admitted to SCI and requiring the placement of a central venous catheter (CVC) between 2007- 2010. We recorded the number of CVC Lines Days on each SCI Unit, catheter-related infections and the CRBSI rate during the FY 07 through FY 10. The CRBSI rate was calculated by the standard formula of dividing the number of CRBSIs by the number of CVC line-days and multiplying the result by 1000. The result represents the CRBSI as the number of central line infections/1000 central line-days.
RESULTS: The CRBSI rate at our SCI Center was reduced from 4.38 infections per 1000 line days during FY 2007 to 0.32 infections per 1000 line days during FY 2010.
CONCLUSIONS: The CRBSI rate at our SCI Center demonstrated a statistically significant decrease between FY 07 and FY 10 with a P value of 0.00006 between the means.
CLINICAL IMPLICATIONS: Our data confirmed that the implantation of evidence-based practice guidelines in the care of CVCs could be instrumental in reducing CRBSI rate. Such approach is undoubtedly most successful when all bundle components are executed simultaneously.
DISCLOSURE: The following authors have nothing to disclose: Linda Smith, Elamin Elamin
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