Chest
Clinical Investigations in Critical CareThe Effect of an Education Program on the Incidence of Central Venous Catheter-Associated Bloodstream Infection in a Medical ICU
Section snippets
Study Location and Patients
This study was conducted in a medical ICU at a university-affiliated, urban teaching hospital: Barnes-Jewish Hospital (1,400 beds). The medical ICU (19 beds) is a closed unit with a multidisciplinary team providing patient care under the direction of attending physicians who are board certified in critical care medicine. Nurse staffing is maintained at a ratio of two patients per nurse, and central venous catheters are usually inserted by resident physicians. During a 4-year period (January
Results
During the 24-month preintervention period (calendar years 2000 and 2001), a total of 74 episodes of catheter-associated bloodstream infection occurred during a total of 7,876 central vein catheter-days. This calculated to an infection rate of 9.4 per 1,000 catheter-days. During the postintervention period (calendar years 2002 and 2003), a total of 41 episodes of catheter-associated bloodstream infections were recorded of a total of 7,455 central vein catheter-days. This is equivalent to an
Discussion
Our study demonstrated that an education program directed at nurses and physicians working in the medical ICU setting may significantly reduce the incidence of catheter-associated bloodstream infection. The observed 41.5% decrease in the rate of bloodstream infection from 9.4 per 1,000 catheter-days to 5.5 per 1,000 catheter-days was associated with an estimated cost savings of between $103,600 and $1,573,000. This study demonstrates that an education-based intervention aimed at optimizing the
ACKNOWLEDGMENT
The authors thank Ms. Linda Brockman for assistance in preparing this manuscript, and the nursing staff of the BJH Medical Intensive Care Unit for their clinical efforts.
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This work was supported by funding from the Centers of Disease Control and Prevention Cooperative Agreement, grant U50/CCU717925, and the Barnes-Jewish Hospital Foundation.