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Epidemiol Infect. 2016 Jul;144(9):2011-7. doi: 10.1017/S0950268815003313. Epub 2016 Jan 13.

Effectiveness of a programme to reduce the burden of catheter-related bloodstream infections in a tertiary hospital.

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Department of Preventive Medicine,Alicante University General Hospital,Alicante,Spain.
Department of Microbiology,Alicante University General Hospital,Alicante,Spain.
Infection Disease Unit,Alicante University General Hospital,Alicante,Spain.
Department of Community Nursing,Preventive Medicine and Public Health and History of Science,Alicante University,Carretera de San Vicente del Raspeig,Alicante,Spain.


The objective of this study was to assess the effectiveness of a catheter-related bloodstream infection (CR BSI) reduction programme and healthcare workers' compliance with recommendations. A 3-year surveillance programme of CR BSIs in all hospital settings was implemented. As part of the programme, there was a direct observation of insertion and maintenance of central venous catheters (CVCs) to determine performance. A total of 38 education courses were held over the study period and feedback reports with the results of surveillance and recommendations were delivered to healthcare workers every 6 months. A total of 6722 short-term CVCs were inserted in 4982 patients for 58 763 catheter-days. Improvements of compliance with hand hygiene was verified at the insertion (87·1-100%, P < 0·001) and maintenance (51·1-72·1%, P = 0·029) of CVCs; and the use of chlorhexidine for skin disinfection was implemented at insertion (35·7-65·4%, P < 0·001) and maintenance (33·3-45·9%, P < 0·197) of CVCs. There were 266 CR BSI incidents recorded with an annual incidence density of 5·75/1000 catheter-days in the first year, 4·38 in the second year [rate ratio (RR) 0·76, 95% confidence interval (CI) 0·57-1·01] and 3·46 in the third year (RR 0·60, 95% CI 0·44-0·81). The education programme clearly improved compliance with recommendations for CVC handling, and was effective in reducing the burden of CR BSIs.


Catheter-related bloodstream infection; central venous catheter; prevention; programme evaluation

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