Central venous catheter-related infection: a cohort study evaluating dedicated central venous catheter packs
© BioMed Central Ltd 2009
Published: 11 November 2009
Central venous catheter (CVC)-related bloodstream infections (CRBSI) are the third most common healthcare-associated infection (HAI) in ICUs, associated with significant morbidity, mortality, increased length of stay and costs [1, 2]. Several care bundle studies have suggested that utilising various strategies together (such as training, regular lines monitoring and using dedicated line insertion trolleys) can have a positive impact on CRBSI rates [3–6]. However, the impact solely attributable to the provision of a dedicated, stand-alone CVC insertion pack has not been evaluated. We therefore investigated the impact of a new EPIC2 compliant CVC pack, introduced in Good Hope Hospital in 2007, on CVC tip colonisation rates.
Data were collected prospectively between June 2007 and December 2008. Patients were divided into two cohorts: patients whose CVCs were inserted using the CVC packs (B), and those receiving CVCs prior to the introduction of the packs (nB). Data were collated from questionnaires as well as patients' notes on: patient's age and sex; type and site of CVC inserted; location at the time of insertion; the grade of practitioner; and the duration CVCs remained in situ. Using the hospital's patient information system and patient notes, data on CVC tip cultures were obtained. Data are presented as percentages and analysed using multivariate analysis.
Our results indicate that use of dedicated CVC packs was associated with a significant reduction in the colonisation rate of CVCs, despite lines being left in situ for longer periods and the more frequent use of quinlumen catheters in the intervention group. There was also a trend toward prevention of MRSA colonisation.
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