Impact of a Multimodal Infection Control Intervention on Central Line-Associated Bloodstream Infections in the ICU

Area of Science:

• Infectious Diseases
• Healthcare Epidemiology
• Critical Care Medicine

Background:

• Central line-associated bloodstream infection (CLABSI) is a significant healthcare-associated infection in intensive care units (ICUs).
• Effective infection control strategies are crucial for reducing CLABSI incidence.

Purpose of the Study:

• To evaluate the impact of a multimodal infection control intervention on CLABSI incidence in ICUs.
• To assess temporal trends in CLABSI rates following intervention implementation.

Main Methods:

• A quasi-experimental study was conducted in adult ICUs.
• Interventions included staff education, feedback, infection control rounds, catheter practice optimization, and environmental hygiene reinforcement.
• Interrupted time-series analysis with segmented Poisson regression assessed CLABSI trends.

Main Results:

• While overall CLABSI incidence did not significantly differ between pre- and post-intervention periods, interrupted time-series analysis revealed a significant monthly decreasing trend (rate ratio, 0.89; p=0.01).
• This trend persisted despite increased patient severity and use of advanced therapies.
• Improved adherence to catheter-handling protocols and reduced femoral venous access were noted.

Conclusions:

• A staged, multimodal intervention demonstrated a significant decreasing trend in CLABSI incidence over time.
• Comprehensive infection prevention strategies show potential benefits in ICU settings.
• Continued focus on infection control is vital for patient safety in ICUs.