Effect of a multidisciplinary intervention on central line utilization in an acute care hospital

Abstract

Many institutions that have adopted evidence-based infection prevention practices have achieved reductions in the rate of central line-associated bloodstream infection (CLABSI) in their intensive care units (ICUs). Few studies have investigated the impact of CLABSI prevention strategies in non-ICU settings, however. This study was conducted to assess whether a multifaceted educational initiative significantly improved health care workers' adherence to clinical practices that have been demonstrated to reduce CLABSI rates. This prospective interventional study compared central line utilization and other variables in medical ICU (MICU) and non-ICU settings at an inner city community teaching hospital. The study included 3 phases: preintervention, intervention, and postintervention. A total of 128 central venous catheter (CVC) placements were reviewed. After the intervention, the proportion of patients transferred out of the MICU with a CVC in place decreased significantly (P=.05), and the percentage of patients transitioned from a CVC to a peripherally inserted venous catheter increased (P= .004). The mean duration of CVC use decreased from 8.2 days to 5.7 days (P=.004), which was confirmed by linear regression (P= .003). Our data indicate that multidisciplinary, evidenced-based educational interventions can significantly improve targeted measures of CVC use. Our program was successfully implemented with limited resources and should be reproducible at other hospitals.