Effectiveness of insertion care bundle to prevent Central-line-associated bloodstream infections at Pediatric ICU

Abstract

Purpose: Central-line-associated bloodstream infections are the most common healthcare- associated- associated infections in Pediatric intensive care units worldwide. The aim of this survey was to quantify the impact of central-line care bundle insertion to the prevention Central-line-associated bloodstream infections in a Greek Pediatric Intensive Care Unit. Methods: All patients with non- tunneled central venous catheter admitted to the unit between October 2012 and October 2015 were included in the cohort study. After twenty-six months of surveillance, a Central-line-associated bloodstream infections prevention insertion bundle was introduced. The insertion bundle derived from the Centers for Disease Control and Prevention recommendations. Results: One hundred fifty one patients were enrolled in the present study. The incidence rates of CLABSIs decreased from 14.0 (pre-intervention period) to 4.8 (post-intervention period) per 1000 central venous catheter-days (p = 0.041, 95% Confidence Interval: 0.7023- 17.7), whilst the central-line utilization ratio was increased from 0.51 to 0.59 (p=<0.002, 95% Confidence Interval: 0.039-0.1258). The insertion-bundle compliance was 95.3% in the post- intervention period. Conclusions: According to the results the implementation of insertion bundle has the potential to reduce the incidence of Central-line-associated bloodstream infections. A prevention strategy targeted on the insertion of vascular access can decrease the incidence rates of Central-line-associated bloodstream in pediatric intensive care units.