投稿分類 感控監測

主委發表種類: 壁報

投稿標題(中): Effect of a bundle care program in reducing central line-associated bloodstream infections at an med

投稿標題(英): Effect of a bundle care program in reducing central line-associated bloodstream infections at an medical center

投稿摘要: Abstract
Background: Central line-associated bloodstream infection (CLABSI) has been the leading cause of healthcare-associated infections (HAIs) in the intensive care unit (ICU) setting. Previous studies have shown that bundle care is effective in reducing CLABSI rates; however, targeting zero remains difficult for many institutions. This study aimed to assess the effect of a bundle care program in ICUs and clarify the continued challenges after program implementation .
Methods: During January 2011 to December 2015, a prospective surveillance was performed to monitor CLABSI at an university hospital in northern Taiwan. To reduce CLABSI rate, a hospital-wide bundle care program for CLABSI prevention was implemented in 2013. We evaluated the change in the incidence and causative pathogens of CLABSI in ICUs after implementing a bundle care program.
Results: The overall CLABSI incidence was 8.22 per 1,000 catheter-days in 2011, and decreased to 5.81 catheter-days in 2015, respectively (P for trend ＜0.001). The most common pathogens causing CLABSI were gut organisms (754/1255, 60.1%), followed by environmental (362/1255, 28.8%) and skin organisms (116/1255, 9.2%). The microbiologic distribution was similar before and after implementation of bundle care program. The decreasing trend was statistically significant in the incidence of CLABSI caused by skin, environmental, and gut organisms (P for trend 0.046, 0.030, and 0.001 respectively). In the multivariable analysis, implementation of bundle care program was independently associated with decreasing CLABSI rate (RR, 0.80; 95% CI 0.68-0.96).
Conclusion: Implementation of bundle care program reduced CLABSI caused by different origins of organisms. The long-term effect of CLABSI needs further investigations.

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