Impact of team-based approach on preventing central line associated bloodstream infection in critically ill setting

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  • HAMANA Akihiro
    Department of Pharmacy, Osaka General Medical Center
  • OHASHI Akiho
    Department of Pharmacy, Osaka General Medical Center
  • YOSHIMURA Jumpei
    Department of Traumatology and Acute Critical Medicine, Osaka University Graduate School of Medicine
  • FUJITA Keiko
    Department of Pharmacy, Osaka General Medical Center
  • FUJIMI Satoshi
    Division of Trauma and Surgical Critical Care, Osaka General Medical Center

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Other Title
  • 多職種による中心静脈ライン関連血流感染症予防の有効性に関する検討
  • タショクシュ ニ ヨル チュウシン ジョウミャク ライン カンレン ケツ リュウカンゾメショウ ヨボウ ノ ユウコウセイ ニ カンスル ケントウ

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Abstract

<p>Background: One of the most important strategies to prevent of Central line associated bloodstream infection (CLABSI) is to minimize the duration of central venous catheterization (CVC). We built a medical team consisting of doctors, nurses and pharmacists to discuss whether patients needed CVC, and recommend catheter removal to attending physicians every day. The purpose of this study was to evaluate whether our team-based approach could shorten the total duration of catheterization and reduce the onset of CLABSI.</p><p>Methods: This was a retrospective historical control study in the Intensive Care Units of a tertiary care hospital in Japan. Every patients admitted to the ICU during the study period were eligible if they were inserted CVC. Patients were divided into following two groups: Conventional group and Interventional group. We set the primary endpoint as onset of CLABSI. The secondary endpoints included the duration of CVC, inhospital mortality etc.</p><p>Results: We included 311 in the Conventional group and 324 in the Interventional group. The reduced tendency of CLABSI was significantly observed in the Interventional group [Odds ratio, 0.262 (95% confidence interval, 0.074-0.929; p=0.030)]. The Interventional group was significantly associated with reduced duration of central venous catheterization (4 days vs 6 days; p<0.001). No differences were observed for secondary endpoints.</p><p>Conclusion: The team-based approach to assess CVC necessity could shorten the duration of central venous catheterization and might reduce CLABSI.</p>

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