Establishing catheter-related bloodstream infection surveillance to drive improvement

Area of Science:

• Healthcare Quality Improvement
• Infection Prevention and Control
• Medical Surveillance

Background:

• Catheter-related bloodstream infections (CRBSI) are a significant complication of central venous access devices.
• CRBSI are often poorly measured, hindering effective management.
• This study details a hospital trust's process for establishing CRBSI surveillance and reduction strategies.

Purpose of the Study:

• To establish a comprehensive surveillance process for CRBSI across all hospital specialties.
• To implement a quality improvement program aimed at reducing CRBSI rates.
• To effectively measure the impact of interventions on CRBSI incidence.

Main Methods:

• Development and application of locally adapted CRBSI criteria.
• Utilization of root cause analysis (RCA) for investigating CRBSI cases.
• Implementation of a multi-specialty surveillance program over five years.

Main Results:

• A significant and sustained reduction in CRBSI rates was observed.
• CRBSI incidence decreased from 5 to 0.23 per 1000 catheter days.
• The surveillance system successfully monitored CRBSI trends throughout the trust.

Conclusions:

• The established surveillance system enabled effective monitoring of CRBSI rates.
• The quality improvement initiatives led to a measurable and substantial reduction in CRBSI.
• This approach provides a model for other institutions seeking to reduce CRBSI.