Prolonged use of intravenous administration sets on central line associated bloodstream infection, nursing workload and material use: A before-after study.

Autor: van de Pol I; Intensive Care Unit, St. Antonius Hospital, Nieuwegein, The Netherlands. Electronic address: i.van.de.pol@antoniusziekenhuis.nl., Roescher N; Department of Clinical Microbiology and Immunology, St. Antonius Hospital, Nieuwegein, The Netherlands., Rigter S; Departments of Anesthesiology and Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands., Noordzij PG; Departments of Anesthesiology and Intensive Care, St. Antonius Hospital, Nieuwegein, The Netherlands; Department of Anesthesiology and Intensive Care, UMC Utrecht, The Netherlands.
Jazyk: angličtina
Zdroj: Intensive & critical care nursing [Intensive Crit Care Nurs] 2023 Oct; Vol. 78, pp. 103446. Date of Electronic Publication: 2023 May 19.
DOI: 10.1016/j.iccn.2023.103446
Abstrakt: Objectives: One of the interventions to reduce risk of central line associated bloodstream infection (CLABSI) is routine replacement of the intravenous administration sets. Guidelines advises a time interval that ranges between four and seven days. However many hospitals replace intravenous administration sets every four days to prevent CLABSI.
Research Methodology: In this single centre retrospective study we analysed whether the extension of the time interval from four to seven days for routine replacement of intravenous administration sets had impact on the incidence of CLABSI and colonization of the central venous catheter. Secondary outcomes were the effects on nursing workload, material use and costs.
Results: In total, 1,409 patients with 1,679 central lines were included. During the pre-intervention period 2.8 CLABSI cases per 1,000 catheter days were found in comparison with 1.3 CLABSI cases per 1,000 catheter days during the post-intervention period. The rate difference between the groups was 1.52 CLABSI cases per 1,000 catheter days (95% CI: -0.50 to +4.13, p = 0.138). The intervention resulted in a saving of 345 intravenous single use plastic administration sets and 260 hours nursing time, and reduced cost with an estimate of at least 17.250 Euros.
Conclusion: Extension of the time interval from four to seven days for routine replacement of intravenous administration sets did not negatively affect the incidence of CLABSI.
Implications for Clinical Practice: Additional benefits of the prolonged time interval were saving of nursing time by avoiding unnecessary routine procedures, the reducing of waste because of reducing the use of disposable materials and healthcare costs.
Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
(Copyright © 2023 Elsevier Ltd. All rights reserved.)
Databáze: MEDLINE
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