Effect of central line bundle on central line-associated bloodstream infections in intensive care units

BackgroundThis study was conducted in 4 intensive care units (ICUs) to investigate the effect of the central line (CL) bundle on central line-associated bloodstream infection (CLABSI).MethodsDuring phase 1 (baseline, from April 2009 to March 2010), active surveillance and training on hand hygiene only were conducted. During phase 2 (intervention, from April 2010 to December 2011), systemic training on the CL bundle and active surveillance and feedback with an electronic CL insertion checklist were performed.ResultsAdherence to the CL bundle significantly increased from 0.0% in phase 1 to 37.1% in phase 2 (P < .001), but the change of CLABSI rate was insignificant for adults in ICUs. However, adherence to the CL bundle significantly increased from 0.8% in phase 1 to 20.1% in phase 2 (P < .001), and the CLABSI rate significantly decreased from 3.7 to 0.0 per 1,000 catheter-days (P = .014) for children in ICUs.ConclusionThe higher adherence to the CL bundle was not positively correlated to a reduction in the CLABSI rate in adults, but it was related to a zero CLABSI for 18 monts among children in the ICUs.