Quality Initiative Program to Reduce Central Line Associated Blood Stream Infection In A Quaternary Care Hospital in India

Dr Maya Pillai1, Dr.   Anup Warrier1, Dr. Sonya Joy1, Ms Soumya  Bernadit1, Mr Kevin Charles1

1Aster Medcity, Kochi, India

Background:

Central line-associated bloodstream infection (CLABSI), defined as a laboratory- confirmed bloodstream infection not related to an infection at another site that develops within 48 hours of a central line placement, causes prolonged hospitalization, increase in health care costs and increased mortality.

In March 2019 the CLABSI rate in Aster Medcity, was 8.15/1000 device days, well over the hospital bench mark. The infection control department,to reduce the rate, initiated a CLABSI reduction program immediately.

Action:

The CLABSI reduction program started with retraining of Healthcare personnel (HCP) in basic infection control practices, insertion and maintenance of central lines. Feedback of rates, done monthly till then, were now being done weekly through the Chief of medical Services and possible lapses in care were analyzed. Indication for insertion of central lines were audited. A CLABSI reduction month Program, was then started to increase the awareness of the HCP to the problem and bring about a behavioral change. This month included number of activities like culture of safety survey, CLABSI prevention posters on display, Live demonstrations on insertions and maintenance on a Central line mannequin, Competency assessment of clinicians and nurse.

Results:

Since the initiation of the program, the CLABSI rates have decreased from 8.15 to  5.5 in the month of May. With the ongoing CLABSI reduction month, the rates are likely to come down further.

Conclusion:

Competency assessments and feedback from direct supervisors, along with a demand for accountability from the top management is effective in improving IPC practices and reducing CLABSI rates.


Biography:

Dr.Maya completed her graduate medical training from Kasturba Medical College, Mangalore, India. Following her master’s in Clinical Microbiology from Christian Medical College, Vellore, she worked as post doctoral Fellow in the Laboratory of Bacterial Genetics in the Center for DNA fingerprinting and Diagnostics. She has done a diploma in ‘Global Strategy of Hospital Hygiene’ from Claude Bernard Lyon University, France and World Health Organization, EMRO, Cairo.  She also worked as Consultant  Microbiologist in KG hospital, Coimbatore  and  at Aster Medcity, Kochi. Her current area of focus is Infection control at Aster DM healthcare.

 

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