The Effect of Central Venous Catheter Maintenance Bundle Implementation on Central Line Associated Infection Rate in the Intensive Care Unit

Abstract

Background: Central venous catheters (CVC) play an important role in the treatment of hospitalized critically ill patients. To improve patient outcome and to reduce healthcare costs, there is considerable interest by healthcare providers in reducing the incidence of Central line associated blood stream infections. OBJECTIVE: This study aims to evaluate the efficacy of the implementation of CVC bundle to all patient admitted in intensive care unit with central line on the reduction of the rate of central line associated blood stream infection. SETTINGS/DESIGN: Quasi-experimental before and after study design conducted in intensive care unit of King Abdullah Medical City, Makkah. SUBJECTS AND METHODS: This study was targeting all patient with central line in intensive care unit. At the time of central line insertion bundle was initiated and maintained until the removal of central line over 12 months period started on December-2018 and ended on December-2019. RESULTS: Study result show a significant reduction (77%) of CLABSI rates, before and after CVC maintenance bundle implementation, which show the effectiveness of bundle implementation on ICU patient and also there is improvement in site selection, subclavian site selection has been increases to 27% during post bundle period compare to 9.5% before pre bundle period, so this improvement may have some impact on the result of CLABSI. Despite study intervention there was slight improvement in insertion bundle compliance rate increase from 89% to 96% over twelve months during study period. CONCLUSION: The study found the effectiveness of central line bundle implementation on ICU patient; this result been achieved with presence of high compliance to the element of bundle by ICU nurses. Looking to CLABSI cases before and after bundle implementation, variable which been observed were close to each other.