Education and performance feedback effect on rates of central vascular catheter–associated bloodstream infections in newborn intensive care units in a private hospital in Colombia

BACKGROUND/OBJECTIVE: To ascertain the effect of an infection control program utilizing education and performance feedback on rates of intravascular device (IVD)-associated bloodstream infection (BSI) in a newborn intensive care unit (NICU). METHODS: The study was conducted in a Level III NICU in a private hospital in Sucre, Colombia, and included all newborn patients admitted to study units who had a central vascular catheter (CVC) in place for >24 hours. A prospective before and after trial in which rates of IVD-associated BSI were determined during a period of active surveillance without education and performance feedback (phase one) were compared to rates of IVD-associated BSI after implementation of an infection control program utilizing education and performance feedback (phase two). Phase one was from October 2003 to April 2004, and phase two was from May 2004 to November 2004. RESULTS: 73 IVD-days were accumulated in phase one, and 166 days during phase two. Compliance with handwashing and CVC site care improved from baseline during the study period. Overall rates of IVD-associated BSI were significantly lowered from baseline rates after implementation of education and performance feedback, from 54.8 BSI per 1000 CVC days (4/73) to 6.0 BSI per 1000 CVC days (1/166), RR = 0.11, 95% CI = 0.01 – 0.98, p = 0.0163). The BSI rate reduction was 89% in 6 months. CONCLUSION: Implementation of an infection control program, utilizing education and performance feedback, resulted in significant reductions in rates of IVD-associated BSI.