Continuing Evolution of Multidisciplinary Approach to Prevention of Central Line–Associated Bacteremias

Continuing Evolution of Multidisciplinary Approach to Prevention of Central Line–Associated Bacteremias Pages E40-E41 L. L. Fauerbach*, C. Ruse, M. A. Gross, R. Kelly, D. Danek, L. Larson, J. Janelle Close Close preview | Purchase PDF (63 K) | Related articles | Related reference work articles AbstractAbstract Abstract ISSUE: Prevention of central line–associated bacteremias (BSIc) is a major focus for our 570-bed tertiary/transplant center. Historical risk-reduction strategies include: use of antimicrobial impregnated CVL, CVL insertion tray designed to facilitate total barrier technique compliance, and use of 0.5% chlorhexidine gluconate and 70% alcohol solution (0.5% CHG) for site prep. Our rates increased following market removal of 0.5% CHG. When new 2 % CHG skin prep solution (2% CHG and 70% alcohol) and a CHG–impregnated patch became available, studies to determine impact of these new products were initiated. PROJECT: BSIc surveillance was performed by infection control professionals according to CDC definitions and reported quarterly. Initially, CVL utilization was 151 patients/per day had at least one CVL. Staff was educated about each new product prior to implementation. The skin prep was first changed to 2% CHG. Subsequently, CHG–impregnated patch was introduced. RESULTS: During the study, CVL utilization increased to 220 patients/day with a CVL. Introduction of 2% CHG prep plus the CHG patch resulted in an overall 31% reduction in BSIc, of which a 16% reduction was attributable to the CHG patch. This reduction resulted in averting 135 infections and cost aversion of $2.5 million. LESSONS LEARNED: Implementing new technologies for reducing BSIc must be an ongoing process. The use of 2% CHG skin prep and a CHG-impregnated patch significantly reduced BSIc in our setting. Evaluation and comparison to hospital-specific baseline data is important to determine the impact of the changes on patient safety and cost management.