Indian Journal of Critical Care Medicine

Register      Login

SEARCH WITHIN CONTENT

FIND ARTICLE

Volume / Issue

Online First

Archive
Related articles

VOLUME 23 , ISSUE 7 ( July, 2019 ) > List of Articles

Original Article

Impact of Nursing Education on CLABSI Rates: An Experience from a Tertiary Care Hospital in Eastern India

Ranjita Acharya, Snigdha Ipsita

Keywords : Central line associated bloodstream infections, hand hygiene

Citation Information : Acharya R, Ipsita S. Impact of Nursing Education on CLABSI Rates: An Experience from a Tertiary Care Hospital in Eastern India. Indian J Crit Care Med 2019; 23 (7):316-319.

DOI: 10.5005/jp-journals-10071-23205

License: CC BY-NC 4.0

Published Online: 01-07-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Background and Aims: Central line associated bloodstream infections (CLABSI) have a higher incidence in the intensive care units of developing countries. Materials and Methods: The baseline CLABSI rate in intensive care unit (ICU) was evaluated for 6 months. An educational program for nurses on basic hand hygiene steps was conducted. Objective assessment tests were done to assess their knowledge and percentage of non-compliance with hand hygiene practice. CLABSI rate over the post-intervention 6 month period was assessed. Results: Thirty-four nurses were enrolled. The pre-intervention CLABSI rate was 12.5 per 1000 catheter days, pretest score15.9 +/- 3.35 and 53.4% opportunities for hand hygiene were missed. Post workshop, there was significant (p=0.02) decrease in CLABSI rate i.e. 8.6, improvement in test score17.76+/-2.1(p=0.011) and missed opportunities decreased to 33.75%. 6 months post intervention, percentage of noncompliance with hand hygiene practice were 51.75% and test score was 17 ± 2. Discussion: The effectiveness of educational program on hand hygiene compliance was reflected in the improvement of posttest score, reduced number of missed opportunities and reduction of CLABSI rates in ICU. The posttest scores and hand hygiene compliance, however, decreased 6 months post-intervention necessitating repeated feedbacks and reminders. Conclusion: Educational interventions on hand hygiene can have a significant impact in CLABSI control particularly in ICUs with a high infection rate and resource constraints.


PDF Share
  1. Edwards JR, Peterson KD, Andrus ML, Tolson JS, Goulding JS, Dudeck MA, et al. National Healthcare Safety Network(NHSN) Report, data summary for 2006, issued June 2007.Am J Infect Control 2007;35:290–301.
  2. Vital signs: central line-associated blood stream infections-United States, 2001,2008 and 2009.MMWR Morb Mortal Wkly Rep 2011;60:243–248.
  3. Rosenthal VD. Central line associated bloodstream infections in limited resource countries: a review of literature. Clin Infect Dis 2009;49:1899–1907.
  4. Frasca D, Dayhot-Fizelier C, Mimoz O. Prevention of central venous catheter related infection in the intensive care unit. Crit Care 2010;14:212.
  5. Public Health Agency of Canada(2013).Hand hygiene practices in healthcare settings.
  6. Ellinson K, Haas JP, Aiello AE, Kusek L, Maragakis LL, Olmsted RN, et al. Society for Healthcare Epidemiology of America(SHEA): Strategies to prevent healthcare associated infections through hand hygiene. Infect Control Hosp Epidemiol 2014;35:937–960.
  7. Warren DK, Zack JE, Mayfield JL, Chen A, Prentice D, Fraser VJ et al. The effect of an education program on the incidence of central venous catheter associated bloodstream infection in a medical ICU, Chest 2004;126:1612–1618.
  8. https://www.cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf
  9. Patil HV, Patil VC, Ramteerthkar MN, Kulkarni RD. Central venous catheter related bloodstream infections in the intensive care unit. Indian J Crit Care Med 2011;15:213–223.
  10. Kaur R, Mathai AS, Abraham J. Mechanical and infectious complications of central venous catherisations in a tertiary level intensive care unit in Northern India. Indian J Anaesthesia 2012;56:376–381.
  11. Mehta A, Rosenthal VD, Mehta Y, Chakravarthy M, Todi SK, Sen N, et al. Device associated nosocomial infection rates in intensive care units of seven Indian cities. Findings of the International Nosocomial Infection Control Consortium(INICC).J Hosp Infect 2007;67:168–174.
  12. Grady NP, Alexander M, Burns LA, Dellinger P, Graland, J, Heard SO, et al. Guidelines for the prevention of intravascular catheter related infections,2011.
  13. Southworth SL, Jenamn LJ, Kinder LA, Sell JL. The journey to zero central catheter-associated bloodstream infections: Culture change in an intensive care unit. Critical Care Nurse,2012;32(2),49–54.
  14. Centers for Disease Control and Prevention.”Guidelines for Hand Hygiene in Health-Care Settings.”Morbidity and Mortality Weekly Report 51, no. RR-16;2002 Oct 25.
  15. Lydon S, Power M, McSharry J, Byrne M. Interventions to improve Hand Hygiene Compliance in the ICU: A Systematic Review. Crit Care Med 2017;45:e1165–e1172.
  16. Chavali S, Menon V, Shukla U. Hand Hygiene Compliance among healthcare workers in an accredited tertiary care hospital. Indian Journal of Critical Care Medicine, 2014;18(10),689–693.
  17. Harris BD, Hanson C, Christy C, Adams T, Banks A, Willis TS, Maciejewski ML. Strict Hand Hygiene And Shortened Stays And Cut Costs And Mortality In A Pediatric Intensive Care. Health Affairs,2011;30(9),1751–1761.
  18. Mathai AS, George SE, Abraham J. Efficacy of a multimodal intervention strategy in improving hand hygiene compliance in a tertiary level intensive care unit. Indian Journal of Critical Care Medicine,2011;15(1),6–15.
  19. Haas JP, Larson EL. Measurement of compliance with hand hygiene. J Hosp Infect 2007;66:6–14.
  20. Warren DK, Zack JE, Mayfield JL, Chen A, Prentice D, Fraser VJ, et al. The effect of an education program on the incidence of central venous catheter associated bloodstream infection in a medical ICU, Chest 2004;126:1612–1618.
  21. Sherertz RJ, Ely EW, Westbrook DM, Gledhill KS, Streed SA, Niger B, et al. Education of physicians-in-training can decrease the risk of vascular catheter related infection. Ann Intern Med 2000;132:641–648.
  22. Yilmaz G, Caylan R, Aydin K, Topbas M, Koksal I. Effect of education on the rate of and the understanding of risk factors for intravascular-catheter related infections. Infect Control Hosp Epidemiol 2007;28:689–694.
  23. Guembe M, Perez-Parra A, Gomez E, Sanchez-Luna M, Bustinza A, Zamora E, et al. Impact on knowledge and practice of an intervention to control catheter infection in the ICU. Eur J Clin Microbiol Infect Dis 2012;31:2799–2808.
  24. Centers for Disease Control and Prevention(2016).Bloodstream Infection Event.
  25. Jaggi N, Rodrigues C, Rosenthal VD, Todi SK, Shah S, Saini N, et al. Impact of an international nosocomial infection control consortium multidimensional approach on central line-associated bloodstream infection rates in adult intensive care units in eight cities in India. Int J Infect Dis. 2013 Dec;17(12):e1218–e1224.
  26. Pronovost P, Needham D, Berenholtz S, Sinopoli D, Chu H, Cosgrove S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med. 2006 Dec 28;355(26):2725–2732.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.