Reduction of central-line-associated bloodstream infection (CLABSI) in resource limited, nonintensive care unit (ICU) settings
International Journal of Health Care Quality Assurance
ISSN: 0952-6862
Article publication date: 28 February 2020
Issue publication date: 31 March 2020
Abstract
Purpose
There was limited study available on successful intervention for central-line-associated bloodstream infection (CLABSI) done at nonintensive care unit (ICU) and resources-limited setting. The objective of this study was to design, implement and evaluate a strategy to reduce CLABSI rate in non-ICU settings at general medical wards of Hospital Tuanku Ja'afar Seremban.
Design/methodology/approach
Preinterventional study was conducted in one-month period of January 2019, followed by intervention period from February to March 2019. Postintervention study was conducted from April to July 2019. The CLABSI rates were compared between pre and postintervention periods. A multifaceted intervention bundle was implemented, which comprised (1) educational program for healthcare workers, (2) weekly audit and feedback and (3) implementation of central line bundle of care.
Findings
There was a significant overall reduction of CLABSI rate between preintervention and postintervention period [incidence rate ratio (IRR) of 0.06 (95 percent CI, 0.01–0.33; P = 0.001)].
Practical implications
CLABSI rates were reduced by a multifaceted intervention bundle, even in non-ICU and resource-limited setting. This includes a preinterventional study to identify the risk factors followed by a local adaption of the recommended care bundles. This study recommends resources-limited hospitals to design a strategy that is suitable for their own local setting to reduce CLABSI.
Originality/value
This study demonstrated the feasibility of a multifaceted intervention bundle that was locally adapted with an evidence-based approach to reduce CLABSI rate in non-ICU and resource-limited setting.
Keywords
Acknowledgements
Funding: None. Conflict of interest: The authors have no conflict of interest to declare. The authors would like to thank Dr. Tan Siok Nee, Dr. Chew Huang Yik, Dr. Shakilone Tharmaseelan, and Dr. Liow Jyue Hong for helping in auditing and data collection. We also would like to thank Matron Rohani Binti Othman and the staff nurses of medical department for executing and adhering to the central line care bundle. Finally, we would like to thank our head of department, Dr Noor Lita, for enforcing the central line care bundle among the doctors and staff nurses.
Citation
Poh, K.W., Ngan, C.H., Wong, J.Y., Ng, T.K. and Mohd Noor, N. (2020), "Reduction of central-line-associated bloodstream infection (CLABSI) in resource limited, nonintensive care unit (ICU) settings", International Journal of Health Care Quality Assurance, Vol. 33 No. 2, pp. 210-220. https://doi.org/10.1108/IJHCQA-11-2019-0195
Publisher
:Emerald Publishing Limited
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