Preventing catheter-associated infections in the Pediatric Intensive Care Unit: impact of an educational program surveying policies for insertion and care of central venous catheters in a Brazilian teaching hospital

Abstract

Objectives:To determine the impact of an educational program on the prevention of central venous catheter-related infections in a Brazilian Pediatric Intensive Care Unit. Patients and Methods: All patients admitted to the unit between February 2004 and May 2005 were included in the cohort study in a longitudinal assessment. An educational program was developed based on the Centers for Disease Control and Prevention recommendations for prevention of catheter-associated infections and was adapted to local conditions and resources after an initial observational phase. Incidence of catheter-associated infections was measured by means of on-site surveillance. Results: One hundred eighteen nosocomial infections occurred in 253 patients (46.6 infections per 100 admissions) and in 2,954 patient-days (39.9 infections per 1,000 patient-days). The incidence-density of catheter infections was 31.1 episodes per 1.000 venous central catheter-days before interventions, and 16.5 episodes per 1,000 venous central catheter-days afterwards (relative risk 0.53 [95% CI 0.28-1.01]). Corresponding rates for exit-site catheter infections were 8.0 and 2.5 episodes per 1,000 venous central catheter-days [0.32 (0.07-1.49)], and the rates for bloodstream infections were 23.1 and 13.9 episodes per 1,000 venous central catheter-days, before and after interventions [0.61 (0.32-1.14)]. Conclusion: A prevention strategy targeted at the insertion and maintenance of vascular access can decrease rates of vascular-access infections in pediatric intensive care unit.

Central Line-Associated Bloodstream Infections in Pediatric Intensive Care Unit

“…Recently, multidrug resistant bacteria have been found to be the most common agent for all HAIs forms such as CLABSI, VAP and CAUTI throughout the world. [26][27][28] Some developing countries still have high HAIs rate. The INICC recently reported that the pooled rate of CLABSI, 4.1 per 1.000 central line-days, was nearly 5-fold higher than the 0.8 per 1.000 central line-days reported from comparable US ICUs.…”

A Cohort Study on Nurse-Led Checklist Intervention to Reduce Catheter-Related Bloodstream Infection in an Intensive Care Unit

“…It was demonstrated in this study a causal relationship between the intervention and the reduction of ICS by CVC and sustained reduction after implementation of intervenção [7]. When we analysed the impact of an educational program on the prevention of infections associated with central venous catheters in paediatric intensive care units of university hospitals in our country it was concluded that a strategy focuses on the insertion and maintenance of venous access may decrease the infection rates associated with this acesso [8].…”

The Frequency of Catheter-Related Infections in Children: One-Year Experience

“…Washing of hands, personnel training, skin antiseptics, provision of barrier methods, daily evaluation of the catheters and removal of the catheter when no longer needed are the most important practices to be considered. Studies conducted in pediatric intensive care units demonstrate that in-staff training courses emphasized the reduced rates of infection (9,10). Particular attention has been paid to this rule during catheter set up and care in our unit.…”