Assessment of Knowledge on the Prevention of Central-Line-Associated Bloodstream Infections among Intensive Care Nurses in Poland—A Prospective Multicentre Study

The presence of a central venous catheter (CVC) leads to a high risk of blood infections, which are considered major causes of morbidity, mortality and high medical costs. The aim of this study was to assess the knowledge of nursing staff working in intensive care units (ICUs) regarding the prevention of central-line-associated bloodstream infections (CLABSIs). A nationwide survey was conducted among ICU nurses from August 2016 to April 2017. A modified Polish version of the questionnaire developed by Labeau et al. was used to assess the nurses’ knowledge. Of the 750 questionnaires distributed, 468 were returned. Women accounted for 95.73% of all respondents, and over 80% were university educated. Most of the nurses surveyed (85.9%) had previously received training in CVC guidelines, and thus over 82% rated their knowledge as good or very good. The guidelines introduced in hospitals were the main declared sources of information. In addition, more than half (68%) of respondents also knew the international guidelines. The knowledge of nursing staff in the study area is not sufficient. Studies show that the guidelines for the prevention of CLABSIs in ICUs should be standardized, and continuous training of personnel in this field should be provided.

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Central venous catheter bundle implementation in an intensive care unit in Kuwait: Effect on central line-associated bloodstream infections

10.26226/morressier.56d5ba30d462b80296c95453 ◽

2016 ◽

Author(s):

Mona Salama

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Central Venous

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A Simple Educational Intervention to Decrease Incidence of Central Line–Associated Bloodstream Infection (CLABSI) in Intensive Care Units with Low Baseline Incidence of CLABSI

Infection Control and Hospital Epidemiology ◽

10.1086/655841 ◽

2010 ◽

Vol 31 (9) ◽

pp. 964-967 ◽

Cited By ~ 24

Author(s):

Alfonso Pérez Parra ◽

María Cruz Menárguez ◽

María Jesús Pérez Granda ◽

María Jesús Tomey ◽

Belén Padilla ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Educational Intervention ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Central Venous ◽

Poisson Regression Analysis ◽

Wilcoxon Rank Sum Test ◽

Baseline Incidence

After an educational intervention in 3 intensive care units, 34 central line-associated bloodstream infections occurred in 11,582 central venous catheter [CVC]-days, compared with 45 episodes in 10,661 CVC-days before intervention (4.22 vs 2.94 episodes per 1,000 CVC-days [30.9% reduction]; P = .03, Wilcoxon rank sum test; P = .11, Poisson regression analysis).

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Central-Line–Associated Bloodstream Infections in Québec Intensive Care Units: Results from the Provincial Healthcare-Associated Infections Surveillance Program (SPIN)

Infection Control and Hospital Epidemiology ◽

10.1017/ice.2016.150 ◽

2016 ◽

Vol 37 (10) ◽

pp. 1186-1194 ◽

Cited By ~ 5

Author(s):

Lynne Li ◽

Elise Fortin ◽

Claude Tremblay ◽

Muleka Ngenda-Muadi ◽

Caroline Quach ◽

...

Keyword(s):

Intensive Care ◽

Central Venous Catheter ◽

Intensive Care Units ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Incidence Rates ◽

Surveillance Program ◽

Central Venous ◽

Healthcare Associated

BACKGROUNDFollowing implementation of bundled practices in 2009 in Quebec and Canadian intensive care units (ICUs), we describe CLABSI epidemiology during the last 8 years in the province of Québec (Canada) and compare rates with Canadian and American benchmarks.METHODSCLABSI incidence rates (IRs) and central venous catheter utilization ratios (CVCURs) by year and ICU type were calculated using 2007–2014 data from the Surveillance Provinciale des Infections Nosocomiales (SPIN) program. Using American and Canadian surveillance data, we compared SPIN IRs to rates in other jurisdictions using standardized incidence ratios (SIRs).RESULTSIn total, 1,355 lab-confirmed CLABSIs over 911,205 central venous catheter days (CVC days) were recorded. The overall pooled incidence rate (IR) was 1.49 cases per 1,000 CVC days. IRs for adult teaching ICUs, nonteaching ICUs, neonatal ICUs (NICUs), and pediatric ICUs (PICUs) were 1.04, 0.91, 4.20, and 2.15 cases per 1,000 CVC days, respectively. Using fixed SPIN 2007–2009 benchmarks, CLABSI rates had decreased significantly in all ICUs except for PICUs by 2014. Rates declined by 55% in adult teaching ICUs, 52% in adult nonteaching ICUs, and 38% in NICUs. Using dynamic American and Canadian CLABSI rates as benchmarks, SPIN adult teaching ICU rates were significantly lower and adult nonteaching ICUs had lower or comparable rates, whereas NICU and PICU rates were higher.CONCLUSIONQuébec ICU CLABSI surveillance shows declining CLABSI rates in adult ICUs. The absence of a decrease in CLABSI rate in NICUs and PICUs highlights the need for continued surveillance and analysis of factors contributing to higher rates in these populations.Infect Control Hosp Epidemiol 2016;1–9

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Implementation of central venous catheter bundle in an intensive care unit in Kuwait: Effect on central line-associated bloodstream infections

Journal of Infection and Public Health ◽

10.1016/j.jiph.2015.05.001 ◽

2016 ◽

Vol 9 (1) ◽

pp. 34-41 ◽

Cited By ~ 15

Author(s):

Mona F. Salama ◽

Wafaa Jamal ◽

Haifa Al Mousa ◽

Vincent Rotimi

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Central Venous

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Central line-associated bloodstream infection trend in Brazilian adult intensive care units: an ecological study

The Journal of Infection in Developing Countries ◽

10.3855/jidc.14730 ◽

2021 ◽

Vol 15 (11) ◽

pp. 1744-1749

Author(s):

Alexsandra Gomes Resende de Souza da Silva ◽

Sergiane Bisinoto Alves ◽

Elisângela Eurípedes Resende Guimarães ◽

Jessyca Rodrigues Braga ◽

Heliny Carneiro Cunha Neves ◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Units ◽

Ecological Study ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Coagulase Negative Staphylococcus ◽

Central Venous ◽

Acinetobacter Spp ◽

Utilization Ratio

Introduction: Central line-associated bloodstream infections are the second most frequent infection in intensive care units. It represents an adverse event of significant magnitude, thus threatening the patient safety. The aim of this study was to analyze the historical trend of central line-associated bloodstream infections in patients in intensive care units, the rate of infection, central venous catheter utilization ratio, type of pathogen and their antimicrobial resistance pattern. Methodology: This ecological study was performed at 42 intensive care units from a state capital of the Midwest region of Brazil. Central line-associated bloodstream infections notifications were collected from two databases, the Municipal Coordination for Patient Safety and Infection Control at Healthcare Services, from 2012-2016, and the FormSUS (National Health System Data Processing Company), from 2014-2016. Results: The incidence of central line-associated bloodstream infections was high and stationary in the period (incidence rate of 2.3 to 3.2 per 1,000 catheter days, central venous catheter utilization ratio average 56,9%). The most frequent microorganisms were coagulase-negative Staphylococcus, Klebsiella pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa. Resistance to 3rd and 4th generation cephalosporins and carbapenems were detected among Gram-negative bacteria, and resistance to oxacillin among Gram-positive bacteria. Conclusions: Central line-associated bloodstream infections incidence rates were high, however the historical trend remained stationary in adult intensive care units. Infections were mostly caused by coagulase-negative Staphylococcus, K. pneumoniae, Acinetobacter spp. and Pseudomonas aeruginosa, including multi-drug resistant organisms. These findings point to the need of educational strategies addressing the adherence to established preventive measures and to the rational use of antimicrobials.

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Does continuity in nursing staff matter? A pilot study on correlation of central line-associated bloodstream infections and employee turnover

Antimicrobial Resistance and Infection Control ◽

10.1186/s13756-021-00958-z ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Thomas Scheier ◽

Stefan P. Kuster ◽

Mesida Dunic ◽

Christian Falk ◽

Hugo Sax ◽

...

Keyword(s):

Nursing Staff ◽

Employee Turnover ◽

Rank Correlation ◽

Bloodstream Infections ◽

Central Line ◽

Incidence Rates ◽

Nursing Personnel ◽

Care Hospital ◽

Spearman Rank Correlation ◽

Spearman Rank

Abstract Background Understaffing has been previously reported as a risk factor for central line-associated bloodstream infections (CLABSI). No previous study addressed the question whether fluctuations in staffing have an impact on CLABSI incidence. We analyzed prospectively collected CLABSI surveillance data and data on employee turnover of health care workers (HCW) to address this research question. Methods In January 2016, a semiautomatic surveillance system for CLABSI was implemented at the University Hospital Zurich, a 940 bed tertiary care hospital in Switzerland. Monthly incidence rates (CLABSI/1000 catheter days) were calculated and correlations with human resources management-derived data on employee turnover of HCWs (defined as number of leaving HCWs per month divided by the number of employed HCWs) investigated. Results Over a period of 24 months, we detected on the hospital level a positive correlation of CLABSI incidence rates and turnover of nursing personnel (Spearman rank correlation, r = 0.467, P = 0.022). In more detailed analyses on the professional training of nursing personnel, a correlation of CLABSI incidence rates and licensed practical nurses (Spearman rank correlation, r = 0.26, P = 0.038) or registered nurses (r = 0.471, P = 0.021) was found. Physician turnover did not correlate with CLABSI incidence (Spearman rank correlation, r = −0.058, P = 0.787). Conclusions Prospectively determined CLABSI incidence correlated positively with the degree of turnover of nurses overall and nurses with advanced training, but not with the turnover of physicians. Efforts to maintain continuity in nursing staff might be helpful for sustained reduction in CLABSI rates.

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Estratégia Multidimensional na Redução de Infeção Associada a Cateter Venoso Central em Pediatria

Acta Médica Portuguesa ◽

10.20344/amp.5558 ◽

2016 ◽

Vol 29 (6) ◽

pp. 373

Author(s):

Jorge Rodrigues ◽

Andrea Dias ◽

Guiomar Oliveira ◽

José Farela Neves

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Central Venous Catheter ◽

Bloodstream Infection ◽

Pediatric Intensive Care Unit ◽

Pediatric Intensive Care ◽

Venous Catheter ◽

Central Line ◽

Central Venous ◽

Group 2

Introduction: To determine the central-line associated bloodstream infection rate after implementation of central venous catheter-care practice bundles and guidelines and to compare it with the previous central-line associated bloodstream infection rate. Material and Methods: A prospective, longitudinal, observational descriptive study with an exploratory component was performed in a Pediatric Intensive Care Unit during five months. The universe was composed of every child admitted to Pediatric Intensive Care Unit who inserted a central venous catheter. A comparative study with historical controls was performed to evaluate the result of the intervention (group 1 versus group 2). Results: Seventy five children were included, with a median age of 23 months: 22 (29.3%) newborns; 28 (37.3%) with recent surgery and 32 (43.8%) with underlying illness. A total of 105 central venous catheter were inserted, the majority a single central venous catheter (69.3%), with a mean duration of 6.8 ± 6.7 days. The most common type of central venous catheter was the short-term, non-tunneled central venous catheter (45.7%), while the subclavian and brachial flexure veins were the most frequent insertion sites (both 25.7%). There were no cases of central-line associated bloodstream infection reported during this study. Comparing with historical controls (group 1), both groups were similar regarding age, gender, department of origin and place of central venous catheter insertion. In the current study (group 2), the median length of stay was higher, while the mean duration of central venous catheter (excluding peripherally inserted central line) was similar in both groups. There were no statistical differences regarding central venous catheter caliber and number of lumens. Fewer children admitted to Pediatric Intensive Care Unit had central venous catheter inserted in group 2, with no significant difference between single or multiple central venous catheter. Discussion: After multidimensional strategy implementation there was no reported central-line associated bloodstream infection Conclusions: Efforts must be made to preserve the same degree of multidimensional prevention, in order to confirm the effective reduction of the central-line associated bloodstream infection rate and to allow its maintenance.

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