Ordóñez Rufat Pilar, Polit Martínez Victoria, Escofet Gómez Rosa, Martínez Estalella Gemma
Rev Enferm. 2017 Mar;40(3):39-42.
The channeling of central venous catheters (CVC) is a technique used in intensive care units (ICUs) but it doesn't come without the risk of infection in the placement and subsequent handling.
Evaluate the effectiveness of a prevention of infection following the introduction of new multifactorial strategies in the prevention program Central line-associated bloodstream infection (CLABSI) at ICU.
Comparative descriptive study in two periods, including all patients admitted in multipurpose ICUs of a tertiary hospital 2014. We analyzed 2014 data compared with 2013, to test the impact of new measures CRB prevention program. Variables: number of catheters, number of infections/1000 catheter days and path. Actions carried out were: prospective surveillance of the incidence rate, sequential program multifactorial prevention implementation of different measures, checklist for insertion of new catheters, introduction of weekly monitoring compliance, reporting episodes team are, continuing education for sanitary personal and implementation of the semipermeable transparent dressings with chlorhexidine gel.
The overall incidence density rate decreased from 3.1 episodes/1000 catheter days in 2013 to 2.3 episodes/1000 catheter days in 2014, improving in different units. The utilization ratio of the different accesses was: 35% humeral; 33% jugular; 25% subclavian; 10% femoral, and 13% hemodialysis catheter.
The new measures applied to reduce the bacteremia have allowed a decrease in the rate of infection, what brings closer to the objective of the Bacteremia Zero program.
中心静脉导管(CVC)置管是重症监护病房(ICU)常用的一项技术,但置管及后续操作过程中存在感染风险。
评估在ICU的中心静脉导管相关血流感染(CLABSI)预防项目中引入新的多因素策略后预防感染的效果。
进行两个阶段的比较描述性研究,纳入2014年一家三级医院综合ICU收治的所有患者。我们分析了2014年与2013年的数据,以检验新的预防导管相关血流感染(CRB)措施的影响。变量包括:导管数量、每1000导管日感染数量及感染途径。采取的行动有:前瞻性监测发病率、依次实施多因素预防不同措施、新导管置入核对表、引入每周依从性监测、向团队报告感染事件、对医护人员进行继续教育以及使用含氯己定凝胶的半透性透明敷料。
总体发病密度率从2013年的每1000导管日3.1例降至2014年的每1000导管日2.3例,不同科室均有所改善。不同置管部位的使用率分别为:肱静脉35%;颈静脉33%;锁骨下静脉25%;股静脉10%;血液透析导管13%。
为降低菌血症而采取的新措施使感染率下降,更接近零菌血症项目的目标。