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Effect of Central Line Bundle Compliance on Central Line-Associated Bloodstream Infections

 Kyoung Hwa Lee  ;  Nan Hyoung Cho  ;  Su Jin Jeong  ;  Mi Na Kim  ;  Sang Hoon Han  ;  Young Goo Song 
 Yonsei Medical Journal, Vol.59(3) : 376-382, 2018 
Journal Title
 Yonsei Medical Journal 
Issue Date
Adult ; Bacteremia/epidemiology/etiology/*prevention & control ; Catheter-Related Infections/epidemiology/etiology/*prevention & control ; Central Venous/adverse effects Catheterization ; Central Venous Catheters ; Chlorhexidine/*administration & dosage ; Female ; *Guideline Adherence ; *Hand Hygiene ; Humans ; Infection Control/*methods ; Intensive Care Units/*organization & administration/standards ; Male ; Patient Care Bundles/*methods/statistics & numerical data ; Practice Guidelines as Topic/*standards ; Treatment Outcome
Central venous catheter ; catheter-associated infection ; central line bundle
PURPOSE: The present study aimed to evaluate the effect of central line (CL) bundle compliance on central line-associated bloodstream infections (CLABSIs) in different departments of the same hospital, including the intensive care unit (ICU) and other departments. MATERIALS AND METHODS: The four components of the CL bundle were hand hygiene, use of maximal sterile barrier precautions, chlorhexidine use, and selection of an appropriate site for venous access. Compliance of the CL bundle and CLABSIs were measured for every department [emergency room (ER), ICU, general ward (GW), and operating room (OR)]. A total of 1672 patients were included over 3 years (August 2013 through July 2016). RESULTS: A total of 29 CLABSI episodes (1.73%) were identified, and only 53.7% of the patients completed CL bundles. The performance rates of all components of the CL bundle were 22.3%, 28.5%, 36.5%, and 84.6% for the ER, ICU, GW, and OR, respectively. The highest CLABSI rate was observed in patients of the ICU, for whom all components were not performed perfectly. Conversely, the lowest CLABSI rate was observed for patients of GWs, for whom all components were performed. Among individual components, femoral insertion site [relative risk (RR), 2.26; 95% confidence interval (CI), 1.09-4.68], not using a full body drape (RR, 3.55; 95% CI, 1.44-8.71), and not performing all CL bundle components (RR, 2.79; 95% CI, 1.19-6.54) were significant variables associated with CLABSIs. CONCLUSION: This study provides direct evidence that completing all CL bundle components perfectly is essential for preventing CLABSIs. Customized education should be provided, according to specific weaknesses of bundle performance.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Mi Na(김미나)
Song, Young Goo(송영구) ORCID logo https://orcid.org/0000-0002-0733-4156
Lee, Kyoung Hwa(이경화) ORCID logo https://orcid.org/0000-0003-0033-1398
Jeong, Su Jin(정수진) ORCID logo https://orcid.org/0000-0003-4025-4542
Cho, Nan Hyoung(조난형)
Han, Sang Hoon(한상훈) ORCID logo https://orcid.org/0000-0002-4278-5198
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