Abstract
BackgroundThe Quebec central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) Surveillance Program saw a decrease in CLABSI rates in most ICUs. Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented, if compliance to measures was monitored and its impact on CLABSI incidence rates.MethodsAll hospitals participating in the Quebec healthcare-associated infections surveillance program (SPIN-BACC – n = 48) received a 77-question survey about preventive measures implemented and monitored in their ICU. The questionnaire was validated for construct, content, face validity, and reliability. We used Poisson regression to measure the association between compliance monitoring to preventive measures and CLABSI rates.ResultsForty-two (88%) eligible hospitals completed the survey. Two components from the maximum barrier precautions were used less optimally: cap (88%) and full sterile body drape (71%). Preventive measures reported included daily review of catheter need (79%) and evaluation of insertion site for the presence of inflammation (90%). Two hospitals rewired lines even if an infection was suspected or documented.In adult ICUs, there was a statistically significant greater decrease in CLABSI rates in ICUs that monitored compliance to preventive insertion measures, after adjusting for teaching status and the number of hospital beds (p = 0.036).ConclusionsHospitals participating to the SPIN-BACC program follow recommendations for CLABSI prevention, but only a minority locally monitor their application. Compliance monitoring of preventive measures for catheter insertion was associated with a decrease in CLABSI incidence rates.
Highlights
The Quebec central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) Surveillance Program saw a decrease in CLABSI rates in most Intensive care unit (ICU)
Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented in Quebec ICUs, determine if compliance to these preventive measures was monitored and understand the impact of compliance monitoring on CLABSI incidence rates
Preventive measures implemented at the hospital level (n = 42) Description of participating centers Forty-two of 48 eligible hospitals, representing 47 adult ICUs, 3 Pediatric intensive care unit (PICU), and 5 Neonatal intensive care unit (NICU), completed the survey
Summary
The Quebec central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) Surveillance Program saw a decrease in CLABSI rates in most ICUs. Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented, if compliance to measures was monitored and its impact on CLABSI incidence rates. A surveillance program for central line-associated bloodstream infections (CLABSI) in intensive care units (ICUs) was implemented in the province of Quebec, Canada in 2003 under the purview of the Surveillance provinciale des Infections Nosocomiales (SPIN) network, part of the Institut national de Santé publique du Québec (INSPQ). Given the surveillance trends observed in recent years, we aimed to determine what preventive measures have been implemented in Quebec ICUs, determine if compliance to these preventive measures was monitored and understand the impact of compliance monitoring on CLABSI incidence rates
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