Mohapatra Sarita, Kapil Arti, Suri Ashish, Pandia Mihir P, Bhatia Rohit, Borkar Sachin, Dube Surya Kumar, Jagdevan Amandeep, George Shally, Varghese Bindu, Dabral Jyotsna
Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
Indian J Crit Care Med. 2020 Jun;24(6):414-417. doi: 10.5005/jp-journals-10071-23455.
Patients in the neurointensive care unit have high utilization of devices, thereby increased chance of getting device-associated infection (DAI). Central line-associated bloodstream infection (CLABSI) remains one of the most important DAI. Education remains an important part of the hospital infection control and improves the infection-control practices.
To evaluate the effectiveness of a quality initiative in reducing incidence of CLABSI, a prospective study (January 2017-December 2018) was done estimating CLABSI incidence before and after the intervention. Continuous teaching and training for hand hygiene practice and central-line catheter hub care were used as the tool for this study.
The quality improvement (QI) initiative achieved a 48% reduction in the CLABSI rate from the baseline rate of 8.7 to 4.5 per 1000 catheter days. The overall mortality showed a reduction from 1.5 to 0.05% during the post-intervention period. There was a significant improvement in compliance with the hand hygiene practice and catheter hub care in the post-intervention period.
This study demonstrates adherence to hand hygiene and catheter hub care with continuous teaching, training, and supervision was highly effective in reducing the CLABSI rate.
Central line-associated bloodstream infection is one of the most important DAI causing significant morbidity and mortality in critically ill patient. Our findings support that continuous educational intervention of hand hygiene with and training on the catheter hub care are two most important preventive measures in the reduction of CLABSI incidence.
Mohapatra S, Kapil A, Suri A, Pandia MP, Bhatia R, Borkar S, Impact of Continuous Education and Training in Reduction of Central Line-associated Bloodstream Infection in Neurointensive Care Unit. Indian J Crit Care Med 2020;24(6):414-417.
神经重症监护病房的患者设备使用率高，因此发生与设备相关感染（DAI）的几率增加。中心静脉导管相关血流感染（CLABSI）仍然是最重要的DAI之一。教育仍是医院感染控制的重要组成部分，并能改善感染控制措施。
为评估一项质量改进措施在降低CLABSI发病率方面的有效性，开展了一项前瞻性研究（2017年1月至2018年12月），估计干预前后的CLABSI发病率。将持续进行手卫生实践和中心静脉导管接头护理的教学与培训作为本研究的工具。
质量改进（QI）措施使CLABSI发生率从基线时的每1000导管日8.7例降至4.5例，降低了48%。干预后总体死亡率从1.5%降至0.05%。干预后，手卫生实践和导管接头护理的依从性有显著改善。
本研究表明，通过持续的教学、培训和监督坚持手卫生和导管接头护理，在降低CLABSI发生率方面非常有效。
中心静脉导管相关血流感染是最重要的DAI之一，在重症患者中会导致显著的发病率和死亡率。我们的研究结果支持，持续的手卫生教育干预以及导管接头护理培训是降低CLABSI发病率的两项最重要的预防措施。
莫哈帕特拉S、卡皮尔A、苏里A、潘迪亚MP、巴蒂亚R、博卡尔S，《持续教育与培训对降低神经重症监护病房中心静脉导管相关血流感染的影响》。《印度危重症医学杂志》2020年；24(6):414 - 417。
