AN INTERVENTIONAL STUDY TO DECREASE CENTRAL VENOUS CATHETER RELATED BLOOD STREAM INFECTION IN INTENSIVE CARE UNITS AT ZAGAZIG UNIVERSITY HOSPITAL

Abstract

Background: Catheter related blood stream infection (CRBSI) is a complication of central venous catheter (CVC) use. This Infection particularly in the ICU population results in higher levels of morbidity and mortality coupled with greater costs in terms of care and increased duration of hospital stay. Aim & Objectives: The aim of this study is to improve the safety of patients with CVC via decreasing the incidence of CRBSI in ICUs patients at Zagazig University Hospital through the following objectives: 1- Calculation the incidences of CRBSI in ICUs patients over six months before and after intervention through active surveillance. 2- Assessment the level of the knowledge and adherence of health care providers in ICUs to evidence based guidelines recommended by CDC to decrease the incidences of CRBSI in ICUs patients before and after intervention. 3- Implementation of health education program on ICUs health care providers i.e. providing them by information about evidence based guidelines recommended by CDC to decrease the incidence of CRBSI in ICUs patients.
Subjects & Methods: An interventional study was conducted in surgical and emergency ICUs at Zagazig University Hospital during the academic year between 2011 and 2012. All patients with CVC in the studied ICUs were consecutively enrolled in the study and all health care providers working in the studied units and involved in insertion, maintenance and care of CVC during the period of study were included in the study. The study was carried out through 3 phases. Results: Statistically, there is a significant improvement in physician practice in both ICUs after intervention. The incidence of CRBSI decreased after intervention in surgical ICU but in comparison with that before intervention it was found no significant difference. In emergency ICU, the incidence of CRBSI after intervention is 0% and in comparison with that before intervention it was found a significant difference. Incidence of CRBSI decreased from 6.01/1000 catheter-days to 3.9/1000 catheter-days after intervention in surgical ICU. In emergency ICU, the incidence of CRBSI was 0% after intervention. Conclusion: This study revealed that, implementation of simple education program increased adequacy of knowledge, improved the practice of healthcare providers and reduced CVC blood stream infection rates in ICUs by almost 50%, during the intervention period.
Keywords: Central venous catheter, Blood stream infection, Intensive care unit