Primary blood stream infections resulting from central venous catheter placement are a common cause of excess morbidity, mortality, and increased medical care costs in the intensive care unit. Several recent studies have shown that education programs directed towards health care workers can significantly decrease the incidence of catheter-associated bloodstream infections. Accordingly, our study examines the ability of an education program directed towards nurses and physicians in a medical intensive care unit to decrease the rate of catheter-associated bloodstream infection in a teaching hospital.
A prospective cohort study design was performed over a 4-year period of time with a primary measured endpoint of catheter-associated bloodstream infection. An education program was implemented consisting of lectures to nursing and medical personnel, posters and fact sheets located outside patient rooms, and the administration of an education module based on the guidelines of the Hospital Infection Control Practices Advisory Committee. Objectives of the education program included enhancing awareness of catheter-associated bloodstream infection, reviewing optimal practices for catheter insertion and maintenance, and developing a strategy for the education of physicians. Statistical analysis was performed using Fisher’s exact, chi-square testing and Wilcoxon rank sum test.
74 episodes of catheter-associated bloodstream infection occurred during 7,876 catheter days (9.4 per 1000 catheter days) in the 24 months before the infection prevention intervention. During the post-intervention period, 41 episodes of catheter-associated bloodstream infection occurred during 7,455 catheter days (5.5 per 1000 catheter days) representing a 41.5% (p=0.019) decrease compared with the pre-intervention period. The estimated cost savings associated with this decrease in catheter-associated bloodstream infection was between $103,000 and $1.573 million.
An intervention focused on the education of healthcare providers on the prevention of catheter-associated bloodstream infections led to a dramatic decrease in the incidence of primary bloodstream infections.
Education programs may lead to a substantial decrease in medical care costs, morbidity, and mortality attributed to central venous catheterization when implemented as part of mandatory training.
A. Chen, None.