A Bundled Approach to Decrease the Rate of Primary Bloodstream Infections Related to Peripheral Intravenous Catheters
Background: Peripheral intravenous catheters (PIVs) have been considered as having lower risk of infection than central lines. However, research is limited regarding numbers of primary bloodstream infections related to peripheral lines and prevention of peripheral line-associated bloodstream infections (PLABSI).
Methods: Our aim was to create and monitor compliance with a new PIV maintenance bundle using disinfecting caps and tips and to assess whether this bundle would lead to a decrease in PLABSI rates. Weekly audits were conducted to measure compliance with both the new PIV bundle and our existing central line-associated bloodstream infection (CLABSI) bundle. We also audited the disconnection method used for intravenous line tubing (peripheral and central lines) before and during the study intervention period.
Results: A compliance rate of close to 90% with the use of the disinfecting caps and tips was attained. Using a PLABSI bundle successfully decreased primary bloodstream infections due to PIVs (from 0.57 infections per 1000 patient-days preintervention to 0.11 infections per 1000 patient-days; p < 0.001). We confirmed that improving care for PIVs would decrease primary bloodstream infections associated with these devices.
Conclusions: Using a PIV maintenance bundle including disinfecting caps and tips can effectively lower the rate of primary bloodstream infections attributable to PIV lines.Abstract
Distribution of line types included in the study by time period (pre-intervention, and during the study intervention period).
Compliance with intervention (use of study disinfecting tip) for line disconnection method, pre-intervention (22 Sep 15 to 2 Oct 15) and during the study intervention period (2 Nov 2015 to 5 Jun 2016).
Hospital-wide number of primary bloodstream infections for peripheral and central lines, pre-intervention (January to June 2015) and during the study intervention period (November 2015 to May 2016). Infections were not reported from July to October 2015 because the bundle was under development and some clinicians had begun to implement some of the practices before the official start date. Therefore, the data would not be accurate during that time period.
Average rates of primary bloodstream infections for peripheral and central lines per 1000 patient days, pre-intervention (January to June 2015) and during the study intervention period (November 2015 to May 2016).
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