Volume 5 Supplement 6

International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access

Sustained reduction of catheter-associated bloodstream infections by simulator-training and self-assessment

  • W Zingg1,
  • V Cartier2,
  • C Inan2,
  • S Touveneau1,
  • F Clergue2,
  • D Pittet1 and
  • B Walder2
BMC Proceedings20115(Suppl 6):O13

DOI: 10.1186/1753-6561-5-S6-O13

Published: 29 June 2011

Introduction / objectives

Central line-associated bloodstream infection (CLABSI) is an avoidable complication in central venous catheter (CVC) use.

Methods

In this study at the University of Geneva Hospitals, individual CVCs were prospectively observed hospital-wide in all adult patients. A baseline period (9/2006-12/2006) was followed by an intervention (1/2008-12/2008) and a sustainability period (1/2009-12/2009). Primary outcome was CLABSI. Interventions aimed at catheter insertion by anaesthesiologists and included (1) a comprehensive checklist, (2) a ready-to-use CVC-insertion set, (3) a CVC-insertion cart containing all necessary material, (4) self-assessment of insertion practice using online documentation, (5) simulation-based CVC-insertion training for residents, (6) web-based information site and (7) feedback during postgraduate education. No intervention was done outside the anaesthesiology division.

Results

Anaesthesiologists, intensivists and other physicians placed 1665 (42%), 1693 (43%), and 617 (15%) catheters, respectively. Cumulative catheter-days and median (IQR) dwell-time were 35,914 and 6 (3-11) days, respectively. Most CVCs were jugular (62%), followed by subclavian (23%) and femoral (15%). CLABSI-rates of anaesthesiologists, intensivists and others at baseline, intervention and sustainability were 4.9, 2.9, 2.0 (IRR 0.75; 95%CI 0.57-0.99; p=0.04); 2.7, 1.4, 2.2 (0.96; 95%CI 0.63-1.46; p=0.85); and 1.6, 2.1, 3.9 (1.54; 95%CI 0.83-2.84; p=0.17), respectively.

Conclusion

Improving CVC-insertion results in significant and sustained CLABSI-reduction. We consider self-assessment at catheter insertion and simulation-based training to have contributed most to the success.

Disclosure of interest

None declared.

Authors’ Affiliations

(1)
Infection control programme, University of Geneva Hospitals
(2)
Division of Anaesthesiology, University of Geneva Hospitals

Copyright

© Zingg et al; licensee BioMed Central Ltd. 2011

This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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