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VOLUME 24 , ISSUE 6 ( June, 2020 ) > List of Articles

Original Article

Impact of Continuous Education and Training in Reduction of Central Line-associated Bloodstream Infection in Neurointensive Care Unit

Sarita Mohapatra, Arti Kapil, Ashish Suri, Mihir P Pandia, Rohit Bhatia, Sachin Borkar, Surya Kumar Dube, Amandeep Jagdevan, Shally George, Bindu Varghese, Jyotsna Dabral

Citation Information : Mohapatra S, Kapil A, Suri A, Pandia MP, Bhatia R, Borkar S, Dube SK, Jagdevan A, George S, Varghese B, Dabral J. Impact of Continuous Education and Training in Reduction of Central Line-associated Bloodstream Infection in Neurointensive Care Unit. Indian J Crit Care Med 2020; 24 (6):414-417.

DOI: 10.5005/jp-journals-10071-23455

License: CC BY-NC 4.0

Published Online: 22-10-2020

Copyright Statement:  Copyright © 2020; The Author(s).


Abstract

Background: Patients in the neurointensive care unit have high utilization of devices, thereby increased chance of getting device-associated infection (DAI). Central line-associated bloodstream infection (CLABSI) remains one of the most important DAI. Education remains an important part of the hospital infection control and improves the infection-control practices. Materials and methods: To evaluate the effectiveness of a quality initiative in reducing incidence of CLABSI, a prospective study (January 2017–December 2018) was done estimating CLABSI incidence before and after the intervention. Continuous teaching and training for hand hygiene practice and central-line catheter hub care were used as the tool for this study. Results: The quality improvement (QI) initiative achieved a 48% reduction in the CLABSI rate from the baseline rate of 8.7 to 4.5 per 1000 catheter days. The overall mortality showed a reduction from 1.5 to 0.05% during the post-intervention period. There was a significant improvement in compliance with the hand hygiene practice and catheter hub care in the post-intervention period. Discussion and conclusion: This study demonstrates adherence to hand hygiene and catheter hub care with continuous teaching, training, and supervision was highly effective in reducing the CLABSI rate. Clinical significance: Central line-associated bloodstream infection is one of the most important DAI causing significant morbidity and mortality in critically ill patient. Our findings support that continuous educational intervention of hand hygiene with and training on the catheter hub care are two most important preventive measures in the reduction of CLABSI incidence.


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  1. Lord AS, Nicholson J, Lewis J. Infection prevention in the neurointensive care unit: a systematic review. Neurocrit Care 2018(1). DOI: 10.1007/s12028-018-0568-y.
  2. Balla KC, Rao SPN, Arul C, Shashidhar A, Prashantha YN, Nagaraj S, et al. Decreasing central line blood stream infection through quality improvement. Indian Paediatr 2018;55(9):753–756. DOI: 10.1007/s13312-018-1374-5.
  3. Chauhan K, Pande A, Thakuria B. Hand hygiene: an educational intervention targeting grass root level. J Infect Public Health 2019;12(3):419–423. DOI: 10.1016/j.jiph.2018.12.014.
  4. Johnson L, Grueber S, Schlotzhauer C, Phillips E, Bullock P, Basnett J, et al. A multifactorial action plan improves hand hygiene adherence and significantly reduces central line associated bloodstream infections. Am Jour Infect Cont 2014;42(11):1146–1151. DOI: 10.1016/j.ajic.2014.07.003.
  5. Fisher D, Cochran KM, Provost LP, Patterson J, Bristol T, Metzguer K, et al. Reducing central line–associated bloodstream infections in North Carolina NICUs. Pediatrics 2013;132(6):e1664–e1671. DOI: 10.1542/peds.2013-2000.
  6. Schulman J, Stricof R, Stevens TP, Horgan M, Gase K, Holzman IR, et al. Statewide NICU central-line-associated bloodstream infection rates decline after bundles and checklists. Pediatrics 2011;127(3):436–444. DOI: 10.1542/peds.2010-2873.
  7. Yokoe DS, Anderson DJ, Berenholtz SM, Calfee DP, Dubberke ER, Eilingson KD, et al. A compendium of strategies to prevent healthcare-associated infections in acute care hospitals: 2014 updates. Infect Control Hosp Epidemiol 2014;35(Suppl 2):S21–S31. DOI: 10.1017/s0899823x00193833.
  8. Marschall J, Mermel LA, Fakih M, Hadaway L, Kallen A, O'grady NP, et al. Strategies to prevent central line-associated bloodstream infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35(7):753–771. DOI: 10.1086/676533.
  9. Lo E, Nicolle LE, Coffin SE, Gould C, Maragakis LL, Meddings J, et al. Strategies to prevent catheter-associated urinary tract infections in acute care hospitals: 2014 update. Infect Control Hosp Epidemiol 2014;35(5):464–479. DOI: 10.1086/675718.
  10. Rallis D, Karagianni P, Papakotoula I, Nikolaidis N, Tsakalidis C. Significant reduction of central line-associated blood stream infection rates in a tertiary neonatal unit. Am j of infect control 2016;44(4):485–487. DOI: 10.1016/j.ajic.2015.10.040.
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