Intravascular catheter bloodstream infections: an effective and sustained hospital-wide prevention program over 18 years

Ms Fiona Kimber1, Professor  Peter Collignon1, Mrs Shannon  Broadrick1, Mrs  Wendy  Beckingham1

1Canberra Hospital , Garran , Australia

Introduction: Whole of hospital blood stream infection data surveillance shows trends in data that may not be realised if only targeted blood stream infection surveillance data is collected e.g. only in ICU. Canberra Hospital introduced a hospital-wide surveillance and intervention program in 1998 to reduce the hospital incidence of bloodstream infections (BSIs) caused by intravascular (IV) catheters.

Methods: Prospective surveillance of inpatients and outpatients with positive blood cultures at a 600 plus bed tertiary referral hospital from 1998 to 2016. Prompt review of positive blood cultures with identification of BSIs due to IV catheters and associated preventable factors; weekly team meetings and regular reports to clinical areas, with assistance to implement targeted interventions.

Results: BSI episodes caused by IV catheters fell from 110 per year in 1998 to 43 in 2016. The rate fell from 0.67 to 0.11 per 1000 occupied bed days. This lowered rate from 1998 to 2016, has been sustained and has been kept below 0.20 per 1000 occupied bed days since June 2011. Over the 18 year study period of the entire hospital campus there were over 880 cases of BSI related to IV catheters. Only 60 of these (6.7%) were identified as being from the commonly targeted surveillance area of ICU.

Conclusions: The program was associated with a profound and sustained drop in the number of IV catheter-related BSIs per year at Canberra hospital. Whole of hospital, active surveillance and intervention programs can lead to substantial and sustained reductions in these common life-threatening infections.


Biography:

Fiona Kimber has many years nursing experience within the Australian public health system in areas including both acute and community.  Fiona initially commenced working with the Infection Prevention and Control unit at Canberra Hospital in 2008.  She completed a Post Graduate Certificate in Infection Control in 2010.

She is currently working with Infection Control as Community Coordinator as well as overseeing Blood Stream Infection surveillance.