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A multidisciplinary comprehensive nursing Management Approach for Catheter-related bloodstream infections
Lingli Xu1, Leiwen Tang2, Jianfen Qin1
1Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310000, China.
Insights
A multidisciplinary intervention significantly reduced catheter-related bloodstream infections (CR-BSIs) by improving catheter care practices and reducing dwell time. This quality improvement initiative offers a model for other intensive care units (ICUs) to eradicate CR-BSIs.
Area of Science:
- Healthcare Quality Improvement
- Infection Control
- Patient Safety
Background:
- Catheter-related bloodstream infections (CR-BSIs) are a major cause of hospital-acquired infections, leading to increased costs and mortality.
- Reducing CR-BSI incidence remains a persistent challenge in healthcare settings.
- A gap exists between evidence-based practices and their real-world implementation for CR-BSI prevention.
Purpose of the Study:
- To evaluate the effectiveness of a multidisciplinary organizational intervention in decreasing CR-BSI rates.
- To implement and assess a quality improvement framework aimed at eradicating CR-BSIs.
Main Methods:
- A quality improvement team was formed to implement interventions.
- The FOCUS-PDCA continuous quality improvement model and fishbone diagram were utilized for analysis and enhancement.
- Interventions targeted catheter insertion, maintenance, and removal processes.
Main Results:
- Operational indicators for catheter insertion, maintenance, and removal improved significantly, exceeding 95%.
- Average catheter dwell time decreased from 7.50 days to 3.50 days.
- The quarterly CR-BSI rate dropped from 2.328% to 0.305%.
Conclusions:
- The implemented quality improvement framework successfully reduced CR-BSIs in surgical intensive care units (ICUs).
- The study highlights the importance of bridging the gap between ideal practices and actual implementation.
- The framework serves as a replicable model for other healthcare settings aiming to eliminate CR-BSIs.
Background:
Catheter-related bloodstream infection (CR-BSI) stands as one of the leading causes of hospital-acquired infections, often resulting in high healthcare expenditure and mortality rates. Despite efforts, reducing the incidence of CR-BSI remains a significant challenge.
Objective:
This study aimed to assess the impact of a multidisciplinary organizational intervention on reducing intravenous CR-BSI.
Methods:
A quality improvement team was established to implement various interventions, utilizing the FOCUS-PDCA continuous quality improvement model and fishbone diagram for analysis and improvement.
Results:
After the interventions, operational indicators for catheter insertion, maintenance, and removal improved from 82.50% ± 1.15%, 83.60% ± 1.60%, and 81.60% ± 1.80-95.30% ± 1.00%, 96.20% ± 1.62%, and 97.25% ± 0.50%, respectively. Additionally, catheter dwell time decreased from 7.50 ± 0.85 days to 3.50 ± 0.75 days, and the quarterly infection rate was reduced from 2.328% ± 1.85-0.305% ± 0.95% following the implementation of the intervention.
Discussion:
Despite the available evidence, there remains a noticeable gap between the ideal evidence-based practices and their practical implementation. We aim to eradicate CR-BSIs within the surgical intensive care units (ICUs) of hospitals. To achieve this goal, we have introduced a comprehensive quality improvement framework designed not only to benefit our own ICU but also to serve as a model for implementation in other similar healthcare settings.
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