The Centers for Disease Control and Prevention (CDC) has released a report detailing interventions to help prevent central line bloodstream infections in hospitals. The report was published in the October 14, 2005, issue of Morbidity and Mortality Weekly Report and can be accessed online at http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5440a2.htm.
An estimated 250,000 central line–associated infections occur each year in U.S. hospitals, and 12 to 25 percent of affected patients die from the condition. In 2001, the CDC and the Pittsburgh Regional Healthcare Initiative began a four-year intervention to prevent central line infections in intensive care units. By 2005, infection rates had decreased 68 percent, suggesting that a coordinated infection-control initiative might be an effective way of reducing bloodstream infections in hospitals.
The intervention consisted of the following five components:
Promotion of targeted, evidence-based catheter-insertion practices (i.e., use of maximum sterile barrier precautions during insertion, use of chlorhexidine for skin disinfection before catheter insertion, avoidance of the femoral insertion site, use of recommended insertion-site dressing care practices, and removal of catheters when no longer indicated)
Promotion of an educational module about central line–associated infections and strategies for their prevention
Promotion of standardized tools for recording adherence to recommended catheter insertion practices
Promotion of a standardized list of contents for catheter insertion kits that includes all supplies required to adhere to recommended insertion practices
Measurement of central line–associated infection rates and distribution of data to participating hospitals in confidential quarterly reports to allow comparison of individual unit-specific rates with pooled mean rates from other participating units in the region and pooled mean rates from all other U.S. hospitals participating in the National Nosocomial Infection Surveillance system.
The CDC reports that the results of this intervention suggest that adherence to evidence-based preventive practices can prevent central line infections. It concludes that additional studies are needed to determine whether these success levels can be achieved for other health care-associated infections.