Effect of integrated nursing based on evidence-based medicine to prevent catheter-related bloodstream infection in surgical inpatients

Abstract

Objective To evaluate the role of evidence-based clinical care programs in reducing the catheter related bloodstream infection (CRBSI) rate. Methods Patients implanted with central venous catheter (CVC) were divided into two groups: the general care group (group GC) and the intensive care group (groupIC). Based on the catheter time, each group was divided into two subgroups: short-term group (catheter time was less than 28 days) and long-term group (catheter time was more than 28 days). Based on the guideline from Chinese Medical Association (CMA) and European Society for Parenteral and Enteral Nutrition (ESPEN),we revised the clinical CVC care programs following the standardization of sterilization and aseptic care and applied them to patients from group IC. Patients from group GC were cared according to current CVC nursing routines. The status of CRBSI in each group was compared. Results In group GC, the CRBSI rate in long-term catheter implanted patients increased slightly by 10.40% than that in short-term catheter implanted patients (6.37 vs. 5.77/1 000 catheter days). However, In group IC, the long-term catheter implanted patients experienced a remarkable increase in CRBSI rate with the extent of 108.87% than the short-term catheter implanted patients (5.18 vs. 2.48/1 000 catheter days). Compared with that of the fellows in group GC, the CRBSI rate of short-term catheter implanted patients from group IC declined significantly with the degree of 57.02% (5.77 vs. 2.48/1 000 catheter days). Whereas the CRBSI rate of long-term catheter implanted patients from group IC declined about 18.68% than that of the fellows in group GC (6. 37 vs. 5.18/1 000 catheter days). The difference between two groups had statistical significance (P ＜0. 01). Conclusions The evidence-based clinical CVC care programs following the standardization of sterilization and aseptic care could reduce the CRBSI rate in patients whose catheter day were less than 28 days, but not in patients whose catheter day were more than 28 days. Key words: Central venous catheter; Catheter related bloodstream infection; Prevention; Nursing