Intensivist supervision of resident-placed central venous catheters decreases the incidence of catheter-related blood stream infectionsReportar como inadecuado




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Patient Safety in Surgery

, 2:11

First Online: 30 April 2008Received: 30 January 2008Accepted: 30 April 2008

Abstract

Catheter-related blood stream infections CRBSI cause significant morbidity and mortality. A retrospective study of a performance improvement project in our teaching hospital-s surgical intensive care unit SICU showed that intensivist supervision was important in reinforcing maximal sterile barriers MSB use during the placement of a central venous catheter CVC in the prevention of CRBSI. A historical control period, 1 January 2001–31 December 2003, was established for comparison. From 1 January 2003–31 December 2007, MSB use for central venous line placement was mandated for all operators. However, in 2003 there was no intensivist supervision of CVC placements in the SICU. The use of MSB alone did not cause a significant change in the CRBSI rate in the first year of the project, but close supervision by an intensivist in years 2004–2007, in conjunction with MSB use, demonstrated a significant drop in the CRBSI rate when compared to the years before intensivist supervision 2001–2003, p < .0001. A time series analysis comparing monthly rates of CRBSI 2001–2007 also revealed a significant downward trend, p = .028. Additionally, in the first year of the mandated MSB use 2003, 85 independently observed resident-placed CVCs demonstrated that breaks in sterile technique 34-85, as compared those placements that had no breaks in technique 51-85, had more CRBSI, 6-34 17.6% vs. 1-51 1.9%, p < .01. Interventions to reduce CRBSI in our SICU needed emphasis on adequate supervision of trainees in CVC placement, in addition to use of MSB, to effect lower CRBSI rates.

Electronic supplementary materialThe online version of this article doi:10.1186-1754-9493-2-11 contains supplementary material, which is available to authorized users.

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Autor: Thomas J Papadimos - Sandra J Hensely - Joan M Duggan - James P Hofmann - Sadik A Khuder - Marilyn J Borst - John J 

Fuente: https://link.springer.com/article/10.1186/1754-9493-2-11







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