Preventing bloodstream infection in patients receiving home parenteral nutrition

Area of Science:

• Infectious Diseases
• Clinical Medicine
• Patient Safety

Background:

• Patients on home parenteral nutrition (HPN) face a high risk of catheter-related bloodstream infections (CRBSI).
• Meticillin-sensitive Staphylococcus aureus (MSSA) is a common pathogen causing CRBSI in this vulnerable population.

Purpose of the Study:

• To develop and implement a multidisciplinary enhanced care pathway to reduce MSSA CRBSI.
• To evaluate the effectiveness of the pathway in decreasing CRBSI rates in HPN patients.

Main Methods:

• A multidisciplinary team developed an enhanced care pathway with minimal cost interventions.
• Interventions included improved line/exit site care, staff/parent training, discharge planning, and compliance monitoring.
• The pathway was implemented, and CRBSI rates were compared pre- and post-implementation.

Main Results:

• Mean rates of MSSA CRBSI decreased from 0.93 to 0.23 per 1000 PN days.
• Mean rates of all-cause CRBSI decreased from 1.98 to 0.45 per 1000 PN days.
• The implemented pathway demonstrated significant reductions in infection rates.

Conclusions:

• A multidisciplinary enhanced care pathway is effective in reducing CRBSI in HPN patients.
• This approach can be adapted to prevent healthcare-associated infections in other complex patient groups.
• Minimal cost interventions can yield substantial improvements in patient safety and outcomes.