Reduction of Catheter-Related Bloodstream Infections Rate in Medical Center in Taiwan

Purpose: We designed a project to reduce the CRBSI rate below 4.0‰ in our intensive care unit, further enhance the quality of care of critically ill patients.

Methods: Improvement plans from June 2013thru December 2104,causes of infection included health care workers inadequate CRBSI prevention practices, dressing sterilization step is incorrect, needle puncture site was easy to oozing and implantation and dressing materials without homogenization and dispersed. Improvement plans included providing in-service education, establishing standard procedures of central venous catheter insertion and dressing, used chlorhexidine-impregnated sponges, added CVC bundle car and CVC care checklist.

Results: The CRBSI rate fell to 0.74‰ after implementation. This was significantly below the reduction target of 4.0‰. Even had 10 month of zero infection rate, significantly reduced catheter-related bloodstream infections in our ICU.

Conclusion: According to nosocomial infections surveillance reporting system statistical analysis of Centers for Disease Control(R.O.C) in Taiwan, Healthcare -associated infection rate is 7.54‰ at 2103, among them were Bloodstream infection include 76.97%, and there are 49.25% of the patients had to use the central catheter. Index statistics of Taiwan Clinical Performance Indictor also noted ICU central venous catheter-related bloodstream infection rate was 3-5 ‰. US ICUs every year an average of eighty thousand visitors center catheter-related bloodstream infections, not only result in increased antibiotic use, prolonged hospital stay, but also led to high mortality rate of 22.9%. Every central catheter-related bloodstream infections occur in the case of Taiwan, for an additional cost of medical expenses of about 150,000, the number of days of hospitalization will be extended 16 days. The average catheter-related bloodstream infections rate in our ICU was 11.07‰ from January 2013 thru May 2013,even reach up to 21.74‰ in May. We made up a group to decrease CRBSI rate. Reduce central catheter-related bloodstream infections is a major issue in hospital. We read the most relevant literature countermeasures more similar projects, so we participate in relevant seminars and join chlorhexidine-impregnated sponges program. This project effectively reduced CRBSI. We want to share this experience to help other hospitals and improve quality of critical care units, reduce the number of days of hospitalization and cost of medical expenses.