Implementing peripheral vascular catheter care bundle in a tertiary care hospital: No room for complacency?

Hdl Handle:
http://hdl.handle.net/10147/239133
Title:
Implementing peripheral vascular catheter care bundle in a tertiary care hospital: No room for complacency?
Authors:
Talento, A F; Morris-Downes, M; Thomas, T; Walsh, J; Smyth, E; Humphreys, H; Fitzpatrick, F
Citation:
Clinical Microbiology and Infection (2011) 17 SUPPL. 4 (S368). : May 2011
Publisher:
Wiley-Blackwell
Journal:
Clinical Microbiology and Infection
Issue Date:
May-2011
URI:
http://hdl.handle.net/10147/239133
Additional Links:
http://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2011.03558.x/pdf
Abstract:
Background: Peripheral vascular catheter (PVC)-related infections are an important cause of device related blood stream infection and are potentially preventable. The 2009 Irish guidelines on the prevention of intravascular catheter-related infection recommend introduction of “care bundles” as an important component of an intravascular catheter related infection prevention programme. The PVC care bundle was introduced in Beaumont Hospital, a 750-bed tertiary referral hospital in Dublin on April 2010. We assessed compliance with bundle components and reviewed its impact on the incidence of PVC-related Staphylococcus aureus blood stream infections (SABSI). Methods: Compliance with the PVC care bundle was audited by the Infection Prevention and Control Team in June and November 2010 using the national audit tool. Four components of the PVC care bundle namely, clinical requirement for a PVC, presence of extravasation or inflammation, status of PVC dressings and duration of PVC <72 hours were assessed. In addition, documentation in the daily PVC documentation sheet was assessed. As an outcome measure, the incidence of PVC-related Staphylococcus aureus bacteraemia (SAB) was measured. Results: Overall compliance with the PVC care bundle was 66% and 74% in June and November 2010, respectively. Compliance varied with ward speciality − In November, compliance was 74% in the medical wards, 91% in the surgical wards, 74% in the neurosurgical and ENT wards, 100% in the critical care units and 35% in the renal/transplant wards. Since April 2010, there have been 10 cases of PVC-related SABSI, five of which were in surgical patients. Conclusion: Overall compliance with the PVC care bundle has improved since its hospital wide implementation. There has been a slight decrease in the number of PVC-related SABSI since PVC bundle implementation when compared to 2009. However, the number of PVC-related SAB remains high with half in surgical patients despite these wards having the highest hospital ward compliance. We plan to re-audit these wards to investigate the reasons for this further. We believe that it is therefore essential to measure outcome in addition to process measures (such as care bundles) in order to fully truly reduce PVC-related infection.
Item Type:
Conference Presentation
Language:
en
Keywords:
INFECTION CONTROL; HOSPITALS; MEDICAL DEVICES

Full metadata record

DC FieldValue Language
dc.contributor.authorTalento, A Fen_GB
dc.contributor.authorMorris-Downes, Men_GB
dc.contributor.authorThomas, Ten_GB
dc.contributor.authorWalsh, Jen_GB
dc.contributor.authorSmyth, Een_GB
dc.contributor.authorHumphreys, Hen_GB
dc.contributor.authorFitzpatrick, Fen_GB
dc.date.accessioned2012-08-20T08:21:45Z-
dc.date.available2012-08-20T08:21:45Z-
dc.date.issued2011-05-
dc.identifier.citationClinical Microbiology and Infection (2011) 17 SUPPL. 4 (S368). : May 2011en_GB
dc.identifier.urihttp://hdl.handle.net/10147/239133-
dc.description.abstractBackground: Peripheral vascular catheter (PVC)-related infections are an important cause of device related blood stream infection and are potentially preventable. The 2009 Irish guidelines on the prevention of intravascular catheter-related infection recommend introduction of “care bundles” as an important component of an intravascular catheter related infection prevention programme. The PVC care bundle was introduced in Beaumont Hospital, a 750-bed tertiary referral hospital in Dublin on April 2010. We assessed compliance with bundle components and reviewed its impact on the incidence of PVC-related Staphylococcus aureus blood stream infections (SABSI). Methods: Compliance with the PVC care bundle was audited by the Infection Prevention and Control Team in June and November 2010 using the national audit tool. Four components of the PVC care bundle namely, clinical requirement for a PVC, presence of extravasation or inflammation, status of PVC dressings and duration of PVC <72 hours were assessed. In addition, documentation in the daily PVC documentation sheet was assessed. As an outcome measure, the incidence of PVC-related Staphylococcus aureus bacteraemia (SAB) was measured. Results: Overall compliance with the PVC care bundle was 66% and 74% in June and November 2010, respectively. Compliance varied with ward speciality − In November, compliance was 74% in the medical wards, 91% in the surgical wards, 74% in the neurosurgical and ENT wards, 100% in the critical care units and 35% in the renal/transplant wards. Since April 2010, there have been 10 cases of PVC-related SABSI, five of which were in surgical patients. Conclusion: Overall compliance with the PVC care bundle has improved since its hospital wide implementation. There has been a slight decrease in the number of PVC-related SABSI since PVC bundle implementation when compared to 2009. However, the number of PVC-related SAB remains high with half in surgical patients despite these wards having the highest hospital ward compliance. We plan to re-audit these wards to investigate the reasons for this further. We believe that it is therefore essential to measure outcome in addition to process measures (such as care bundles) in order to fully truly reduce PVC-related infection.en_GB
dc.language.isoenen
dc.publisherWiley-Blackwellen_GB
dc.relation.urlhttp://onlinelibrary.wiley.com/doi/10.1111/j.1469-0691.2011.03558.x/pdfen_GB
dc.subjectINFECTION CONTROLen_GB
dc.subjectHOSPITALSen_GB
dc.subjectMEDICAL DEVICESen_GB
dc.titleImplementing peripheral vascular catheter care bundle in a tertiary care hospital: No room for complacency?en_GB
dc.typeConference Presentationen
dc.identifier.journalClinical Microbiology and Infectionen_GB
dc.description.provinceLeinsteren
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