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Use of central venous catheter-related bloodstream infection prevention practices by US hospitals.

Krein SL, Hofer TP, Kowalski CP, Olmsted RN, Kauffman CA, Forman JH, Banaszak-Holl J, Saint S. Use of central venous catheter-related bloodstream infection prevention practices by US hospitals. Mayo Clinic proceedings. Mayo Clinic. 2007 Jun 1; 82(6):672-8.

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Abstract:

OBJECTIVE: To examine the extent to which US acute care hospitals have adopted recommended practices to prevent central venous catheter-related bloodstream infections (CR-BSIs). PARTICIPANTS AND METHODS: Between March 16, 2005, and August 1, 2005, a survey of infection control coordinators was conducted at a national random sample of nonfederal hospitals with an intensive care unit and more than 50 hospital beds (n = 600) and at all Department of Veterans Affairs (VA) medical centers (n = 119). Primary outcomes were regular use of 5 specific practices and a composite approach for preventing CR-BSIs. RESULTS: The overall survey response rate was 72% (n = 516). A higher percentage of VA compared to non-VA hospitals reported using maximal sterile barrier precautions (84% vs 71%; P = .01); chlorhexidine gluconate for insertion site antisepsis (91% vs 69%; P < .001); and a composite approach (62% vs 44%; P = .003) combining concurrent use of maximal sterile barrier precautions, chlorhexidine gluconate, and avoidance of routine central line changes. Those hospitals having a higher safety culture score, having a certified infection control professional, and participating in an infection prevention collaborative were more likely to use CR-BSI prevention practices. CONCLUSION: Most US hospitals are using maximal sterile barrier precautions and chlorhexidine gluconate, 2 of the most strongly recommended practices to prevent CR-BSIs. However, fewer than half of non-VA US hospitals reported concurrent use of maximal sterile barrier precautions, chlorhexidine gluconate, and avoidance of routine central line changes. Wider use of CR-BSI prevention practices by hospitals could be encouraged by fostering a culture of safety, participating in infection prevention collaboratives, and promoting infection control professional certification.





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