[The impact of closed system and 7 days intravascular administration set replacement on catheter related infections in a general intensive care unit: a before-after study]

Assist Inferm Ric. 2015 Jul-Sep;34(3):125-33. doi: 10.1702/2038.22138.
[Article in Italian]

Abstract

Introduction: The incidence of catheter related Bloodstream infections (BSI) is high in intensive care units (ICU).

Aim: To evaluate the BSI rate in a population of patients admitted to a General ICU before and after the implementation of the 2011 CDC guidelines.

Methods: Retrospective observational study on patients admitted from January 2009 to December 2013. The infusion and monitoring lines were changed every 96 hours for the first 30 months, and every 7 days for the next 30. In all patients a closed infusion line with needle-free connectors pressure was used (Microclave). The following catheters were considered in the study: central venous catheter (CVC), arterial cannula (ART) and Swan Ganz catheter (SG).

Results: During the period with change every 96 hours 15 BSI were observed over 13395 catheters/days (C/D), 1.12 per 1000 C/D, while when lines where changed every 7 days 11 BSI were observed over 13120 C/D, 0.83 per 1000 C/D. A statistically significant reduction of BSI was observed in SG catheters (4.17 vs. no BSI p = 0.02), while the CVCS (1.12 vs 1.45 - p = 0.37) and ART (0.35 vs 0.36 - p = 0.61) infection rates remained unchanged.

Conclusions: The replacement of infusion lines every 7 days in our sample did not increase the BSI, helping to reduce the costs.

Publication types

  • Observational Study

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bacteremia / economics
  • Bacteremia / epidemiology
  • Bacteremia / microbiology
  • Bacteremia / nursing*
  • Catheter-Related Infections / economics
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / etiology
  • Catheter-Related Infections / nursing*
  • Catheterization, Peripheral / adverse effects
  • Catheterization, Peripheral / economics
  • Catheterization, Peripheral / instrumentation
  • Catheterization, Peripheral / nursing*
  • Catheterization, Swan-Ganz / adverse effects
  • Catheterization, Swan-Ganz / economics
  • Catheterization, Swan-Ganz / instrumentation
  • Catheterization, Swan-Ganz / nursing*
  • Central Venous Catheters* / adverse effects
  • Central Venous Catheters* / economics
  • Controlled Before-After Studies*
  • Guidelines as Topic
  • Humans
  • Incidence
  • Intensive Care Units*
  • Italy / epidemiology
  • Middle Aged
  • Retrospective Studies