EXPERIENCE OF CLABSI PREVENTION MEASURES IN A MEDICAL ICU IN A TERTIARY CARE HOSPITAL IN A DEVELOPING COUNTRY

Abstract

TYPE: Abstract TOPIC: Education, Research, and Quality Improvement PURPOSE: To reduce the incidence of CLABSI (central line associated bloodstream infection) in the Intensive care unit (ICU) handling medical patients in a tertiary care setup. METHODS: Baseline data were collected for the first 6 months. Training for doctors, nurses and technicians provided in fixed intervals for implementation of 5 bundles of prevention, especially hand hygiene. RESULTS: There was a significant fall (25.3 Vs 8.1) in CLABSI rate soon after every educational programme conducted. However, it was followed by a rise again. There was no overall improvement in CLABSI rate after the intervention part (18.4 Vs 19.5). However, subgroup analysis showed that the outbreak of flu season in the second part of the year in the intervention phase made the population incomparable, with more ARDS cases in the second half with high SOFA score. CLABSI rate comparison between ARDS population containing months in the first half and the second half was done, which showed 15.5% reduction. Also, there was a significant increase in hand hygiene rate pre and post intervention (p<0.05). CONCLUSIONS: Fall in CLABSI rate in the months soon after the educational programme is evident but it was ill-sustained. Further, overall comparison did not yield significant reduction as the two populations were heterogeneous. However, reduction in CLABSI rate in the ARDS population showed intensive and continuous educational efforts can make significant improvements. CLINICAL IMPLICATIONS: Intensive and continuous teaching programmes can cause significant reduction in CLABSI in resource limited settings which may prove cost effective, when compared to treating resistant infection with costly antibiotics. DISCLOSURE: Nothing to declare. KEYWORD: CLABSI