Reduction of central venous catheter associated blood stream infections following implementation of a resident oversight and credentialing policy
2011

Reducing Bloodstream Infections from Central Venous Catheters

Sample size: 813 publication Evidence: high

Author Information

Author(s): Cherry Robert A, West Cheri E, Hamilton Maria C, Rafferty Colleen M, Hollenbeak Christopher S, Caputo Gregory M

Primary Institution: The Pennsylvania State University, College of Medicine

Hypothesis

The development, implementation, and enforcement of a resident oversight and credentialing policy for CVC placement may result in a decrease in the rate of CLABSI.

Conclusion

The new CVC resident oversight and credentialing policy significantly reduced the rate of CLABSI per 1,000 central line days and total central line days.

Supporting Evidence

  • Median CLABSI rate decreased from 3.52 to 2.26.
  • Number of CLABSI per month reduced from 16.0 to 10.0.
  • Total central line days decreased from 4495 to 4193.
  • No serious adverse events were reported.

Takeaway

This study shows that having residents supervised when placing central lines can help prevent infections.

Methodology

Retrospective analysis of prospectively collected data on CLABSI rates before and after policy implementation.

Potential Biases

Potential for bias due to non-blinded interventions and concurrent performance improvement projects.

Limitations

Baseline data for resident-driven CVC insertions is unknown, and there may be a Hawthorne effect influencing results.

Participant Demographics

Patients undergoing non-tunneled CVC placement in adult and pediatric ICUs.

Statistical Information

P-Value

0.015

Statistical Significance

p<0.05

Digital Object Identifier (DOI)

10.1186/1754-9493-5-15

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