Weekly transparent dressing changes linked to increased bacteremia rates.

Area of Science:

• Infectious Diseases
• Healthcare Quality Improvement
• Epidemiology

Background:

• Primary bloodstream infections (BSIs) doubled in intensive care unit (ICU) patients with central venous catheters in 2000 compared to 1999.
• Cost-saving initiatives in December 1999 altered central line site care products and practices.

Purpose of the Study:

• To identify factors contributing to increased BSIs following the implementation of cost-saving site care measures.
• To evaluate the impact of changes in site care protocols on BSI rates.

Main Methods:

• An epidemiologic study involving prospective infection identification was conducted.
• The study included patients in a medical-surgical ICU with triple lumen or pulmonary artery catheters from 2000-2001.
• Interventions included reintroducing alcohol swab sticks, increasing dressing change frequency, and providing aseptic technique training.

Main Results:

• A significant decrease in primary BSIs (P = .003) was observed during a 3-month intervention period.
• This reduction in BSI incidence was sustained for the subsequent 12 months.
• The study demonstrated a correlation between specific changes in site care and BSI rates.

Conclusions:

• Changes in central line site care, specifically prolonging transparent dressing changes and switching from alcohol swabs to pads, were associated with increased BSIs.
• Reverting to the original site care policy effectively controlled the rise in BSIs.
• Adherence to established protocols for catheter site care is crucial for preventing BSIs in ICU settings.