The role of central venous catheters managers and effectiveness of reduction CLABSI in surgical intensive care unit

Abstract

The role of central venous catheters managers and effectiveness of reduction CLABSI in surgical intensive care unit Sungdae Shin, Yoon joong Jung, Jun ju Lee, Se ra Kim, Soon heang Lee, Hyo keun No, Min ae Keum, Suk-kyung Hong ASAN Medical Center, Republic of Korea Background/Purpose: The use of central venous catheters (CVCs) is an integral part of critical care for the not only injection of medication and parenteral nutrition but also the access of hemodynamic monitoring and hemodialysis. However, CVC-related infections are occurring in 5% to 26% of patients. These serious infectious complications are associated with increased morbidity, mortality, and health care costs. This study is to analyze the effectiveness of CVC managers for the prevention of central line– associated bloodstream infection (CLABSI) between each 9 months in surgical intensive care unit (SICU). Methods:With a retrospective study, the prevalence of CLABSI was compared between the preintervention period (PRE, January 2013 to September 2013) and the postintervention period (POST, October 2013 to June 2014) each 9 months in SICU. CVC manager performed daily rounding to check the condition of CVCs and if required dressing following CDC guidelines. Managers reported to the physicians the status of CVCs as soon as inflammation signs are detected. Results: A total of 242 patients from pre-intervention periods and 196 patients from postintervention periods were analyzed except patients with early discharge within 48 hours and without central line. There is no significant difference between 2 groups related to age, gender, reason for ICU admission, ICU admission route, APACHE II score, ventilator day, and length of stay in ICU. Incidence rate ratio (IRR) was reduced 2.5 in the postintervention (1.46/1000 device days) compared to preintervention (3.67/1000 device days). Conclusions: Because patients in SICU have inserted central line with operation, it is difficult to decrease the use rate. However, it is assumed that organized and constant interventions by CVC managers can effectively decline CLABSI.