Effect of central line bundle on central line-associated bloodstream infections in intensive care units.

BACKGROUND: This study was conducted in 4 intensive care units (ICUs) to investigate the effect of the central line (CL) bundle on central line-associated bloodstream infection (CLABSI).

METHODS: During phase 1 (baseline, from April 2009 to March 2010), active surveillance and training on hand hygiene only were conducted. During phase 2 (intervention, from April 2010 to December 2011), systemic training on the CL bundle and active surveillance and feedback with an electronic CL insertion checklist were performed.

RESULTS: Adherence to the CL bundle significantly increased from 0.0% in phase 1 to 37.1% in phase 2 (P < .001), but the change of CLABSI rate was insignificant for adults in ICUs. However, adherence to the CL bundle significantly increased from 0.8% in phase 1 to 20.1% in phase 2 (P < .001), and the CLABSI rate significantly decreased from 3.7 to 0.0 per 1,000 catheter-days (P = .014) for children in ICUs.

CONCLUSION: The higher adherence to the CL bundle was not positively correlated to a reduction in the CLABSI rate in adults, but it was related to a zero CLABSI for 18 months among children in the ICUs.