Implementing the Central Line Bundle To Reduce Peripherally Inserted Central Catheter (PICC) Bloodstream Infections

Abstract Background: Federal agencies such as the Centers for Disease Control and Prevention have mandated reduction of hospital-acquired infections and recommended the use of antimicrobial catheters in clinical settings where central line-associated bloodstream infection (CLABSI) rates have remained high. The Infusion Nurses Society also recommends antimicrobial catheters for specific patient populations. At a California hospital, evidence-based infection prevention strategies for CLABSI prevention had been in effect for several years, but the CLABSI rate remained at an unacceptable level. For this reason, the effect of an antimicrobial peripherally inserted central catheter (PICC) on the incidence of CLABSI was studied. Methods: A quasiexperimental design was used with concurrent data collection on patients in an intervention group who received an antimicrobial PICC. Retrospective data were collected for patients in a nonintervention group who received nonantimicrobial PICCs the previous year. Results: The 257 patients in the nonintervention group experienced 8 CLABSIs with an infection rate of 4.18/1,000 line days. The 260 subjects in the intervention group experienced 1 CLABSI with an infection rate of 0.47/1,000 line days. The decrease in the number of infections per 1,000 line days for the intervention group was statistically significant. Conclusions: The use of an antimicrobial PICC in conjunction with current infection prevention practices resulted in a statistically significant decrease in infection rate, which supports the recommendation for continued use of antimicrobial catheters. Treatment cost savings, which overcame the higher initial cost for the devices, were found to be an additional benefit of using antimicrobial catheters.

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Central line bundle including split-septum device and single use prefilled flushing syringes for prevention of port associated bloodstream infections: A cost and resource utilization analysis

10.21203/rs.2.15266/v1 ◽

2019 ◽

Author(s):

Ilker Devrim ◽

Mustafa T Ozkul ◽

İlknur Çağlar ◽

Yeliz Oruç ◽

Nevbahar Demiray ◽

...

Keyword(s):

Line Bundle ◽

Cancer Patients ◽

Pediatric Cancer ◽

Bloodstream Infections ◽

Central Line ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Pediatric Cancer Patients ◽

Central Line Bundle

Abstract Background: Central line bundle programs were found to be effective in decreasing central line–associated bloodstream infection rates in pediatric cancer patients with ports. However cost-effectiveness studies of central line bundle programs in pediatric cancer patients are limited and most available data are from intensive care unit or adult studies. Methods: In this 6 years cross-sectional study, comprehensive assessment of total health care costs attributable to CLABSI’s associated with ports between two periods including 3 years of pre-bundle period and bundle period. Results: This cross-sectional study was carried out in the pediatric hematology-oncology ward of Dr. Behçet Uz Children’s Hospital from 1 August November 2011 to 31 July 2017. The CLABSI rates decreased significantly from 8,31 CLABSIs to 3.04 per 1000 central line days ( p <0.0001). In the prebundle period, total attributable costs spent for of patients with CLABSI were $130661,68 and in the bundle period, total attributable costs spent for patients with CLABSI were $116579,05.Within bundle implantation, 71 potential CLABSI were prevented which saved an additional $208977,81. In other words, for one dollar spent for bundle program, $ 6,54 was saved by decreasing the expected CLABSI. Conclusion: our study shows that central line bundles decreases not only the CLABSI rate, but also decreases attributable costs due to CLABSI. Expenses spent for bundle elements, were covered by savings by preventing CLABSI with higher costs

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Impact of number of lumens in central-venous catheters on central-line bloodstream infection (CLABSI) and venous thromboembolism (VTE) risk in patients with acute leukemia

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2021.423 ◽

2021 ◽

pp. 1-3

Author(s):

Alina Varabyeva ◽

Christabel Pui-See Lo ◽

Adamo Brancaccio ◽

Anthony J. Perissinotti ◽

Twisha Patel ◽

...

Keyword(s):

Retrospective Study ◽

Venous Thromboembolism ◽

Acute Leukemia ◽

Bloodstream Infections ◽

Central Line ◽

Central Venous Catheters ◽

Peripherally Inserted Central Catheter ◽

Central Catheter ◽

Central Venous ◽

Double Lumen

Abstract This retrospective study was conducted to determine whether the number of peripherally inserted central-catheter lumens affected the rate of central-line associated bloodstream infections (CLABSIs) in adult patients with acute leukemia. The results show that CLABSI rates were not significantly different between patients with triple-lumen or double-lumen PICCs (22.1% vs 23.4%; P = .827).

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Correction to: Central line bundle including split-septum device and single-use prefilled flushing syringes to prevent port-associated bloodstream infections: a cost and resource-utilization analysis

BMC Health Services Research ◽

10.1186/s12913-020-05299-y ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

İlker Devrim ◽

Mustafa Taha Özkul ◽

İlknur Çağlar ◽

Yeliz Oruç ◽

Nevbahar Demiray ◽

...

Keyword(s):

Line Bundle ◽

Resource Utilization ◽

Bloodstream Infections ◽

Central Line ◽

Single Use ◽

Central Line Bundle

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New Interventions in Addition to the Central Line Bundle which are Associated With a Sustained Reduction of Central Line-associated Bloodstream Infections

American Journal of Infection Control ◽

10.1016/j.ajic.2010.04.185 ◽

2010 ◽

Vol 38 (5) ◽

pp. e136-e138

Keyword(s):

Line Bundle ◽

Bloodstream Infections ◽

Central Line ◽

Sustained Reduction ◽

Central Line Bundle

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Innovative Additions to Central Line Bundle Reduce Bloodstream Infections in Vulnerable Pediatric Patient Population & Improve Catheter Care

American Journal of Infection Control ◽

10.1016/j.ajic.2012.04.066 ◽

2012 ◽

Vol 40 (5) ◽

pp. e39

Author(s):

Marianne Pavia ◽

Heather Painter

Keyword(s):

Line Bundle ◽

Pediatric Patient ◽

Patient Population ◽

Bloodstream Infections ◽

Central Line ◽

Pediatric Patient Population ◽

Central Line Bundle ◽

Catheter Care

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Central line bundle for prevention of central line–associated bloodstream infection for totally implantable venous access devices (ports) in pediatric cancer patients

The Journal of Vascular Access ◽

10.1177/1129729818757955 ◽

2018 ◽

Vol 19 (4) ◽

pp. 358-365 ◽

Cited By ~ 9

Author(s):

İlker Devrim ◽

Yeliz Oruç ◽

Bengü Demirağ ◽

Ahu Kara ◽

Mine Düzgöl ◽

...

Keyword(s):

Line Bundle ◽

Bloodstream Infection ◽

Removal Rate ◽

Bloodstream Infections ◽

Venous Access ◽

Central Line ◽

Pediatric Cancer Patients ◽

Single Use ◽

Venous Access Devices ◽

Central Line Bundle

Objective: The clinical impact of central line bundle programs for central line–associated bloodstream infections has been well demonstrated in intensive care units. However, the experience of central line bundle programs in totally implantable venous access devices (ports) in pediatric-hematology patients was limited. Methods: A retrospective study was designed to compare and evaluate the clinical impact of implementing a central line bundle for a 2-year 5-month period, including 10 months of prebundle period, 11 months of central line bundle (that includes needleless split-septum devices), and finally 8 months of central line bundle period in which single-use prefilled flushing devices were added to the previous central line bundle. Results: During the prebundle period, the rate of 14.5 central line–associated bloodstream infections per 1000 CL-days had decreased to 5.49 CLABSIs per 1000 CL-days in the first bundle period. The incidence rate ratio with these two groups was 0.379, indicating a relative risk reduction of 62% ( p = 0.005). By the addition of single-use prefilled flushing devices to the first bundle program, the central line–associated bloodstream infection rate decreased to 2.63 per 1000 CL-days. Port removal rate due to central line–associated bloodstream infections was 0.46 per 1000 catheter days in the bundle period, which was significantly lower than in the prebundle period in which port removal rate was 4.5 per 1000 catheter days ( p < 0.001). Conclusion: Central line bundle programs were found to be effective in decreasing central line–associated bloodstream infection rates, improving patients’ quality of life by preventing ports removal due in pediatric cancer patients.

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