An intervention to decrease catheter-related bloodstream infections in the ICU

Area of Science:

• Infectious Disease Epidemiology
• Healthcare Quality Improvement
• Critical Care Medicine

Background:

• Catheter-related bloodstream infections (CRBSIs) are a significant threat in intensive care units (ICUs).
• These infections contribute to increased morbidity, mortality, and healthcare costs.
• Effective strategies are needed to mitigate CRBSI incidence.

Purpose of the Study:

• To evaluate the effectiveness of an evidence-based intervention in reducing CRBSI rates.
• To assess the sustainability of the intervention's impact over an 18-month period.
• To analyze CRBSI incidence using rigorous statistical modeling in a multicenter ICU setting.

Main Methods:

• A collaborative cohort study was conducted across 103 intensive care units (ICUs).
• An evidence-based intervention was implemented to target CRBSI reduction.
• Multilevel Poisson regression modeling analyzed infection rates per 1000 catheter-days before, during, and after intervention.

Main Results:

• The study analyzed 1981 ICU-months and 375,757 catheter-days.
• CRBSI rates per 1000 catheter-days decreased significantly from a median of 2.7 at baseline to 0 at 3 months.
• Sustained reductions were observed, with mean rates decreasing from 7.7 to 1.4 at 16-18 months, and incidence-rate ratios decreasing to 0.34.

Conclusions:

• The evidence-based intervention led to a substantial and sustained reduction in CRBSI rates.
• Reductions of up to 66% were maintained throughout the 18-month study.
• This intervention demonstrates a highly effective strategy for improving ICU patient safety by preventing CRBSIs.