This paper was published in the Journal of Hospital Infection August issue by Musu and colleagues.
Background: Bloodstream infections (BSIs) associated with insertion and maintenance of central venous catheters (CR-BSIs) are the most common causes of health care-associated infections in intensive care units (ICUs). They are responsible for increased length of hospital stay and additional health care costs.
Aim: To investigate whether an educational program addressed at healthcare workers resulted in a significant change in the level and trend of infections.
Methods: The research was conducted in five Italian ICUs from July 2012 to August 2014. Surveillance and educational interventions to control infections were applied. Compliance with hand hygiene (HH) procedures was assessed via risk relative analysis and 95% interval confidence. Interrupted time series analysis was used to investigate the change in level and trend of infection during the intervention.
Results: Compliance with HH procedures improved during the intervention for all staff groups, but physicians showed the lowest compliance rates (nurses from 52.4% to 92.1%; nurse aides from 71.0% to 92%; physicians from 71.0% to 92%, p< 0.001). Significant reductions of 21% to 55% in the CR-BSI were observed during the intervention. Small improvements in the monthly infection trend were also observed, but these were not statistically significant.
Conclusions: An educational programme focussing on general good infection control practice, rather than CVC care bundles resulted in a decreased CR-BSI rate, even if the improvement was not sustained over time. Continuous performance feedback should be provided to promote long-term adherence to guidelines among all health workers.
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