英文摘要 |
This program aimed to reduce the incidence of central line-associated bloodstream Infections (CLABSI), as a higher CLABSI incidence of 8.3‰ was observed at the medical respiratory care center in the 3rd quarter of 2017, which was higher than peer medical centers. Underlying reasons to contribute to this trend include patients' immune-compromised status, Gram-negative bacteria as the main pathogen, high prevalence of intravenous antibiotic use, physicians' incomplete compliance to specify the indication to use central lines, lack of a mechanism to analyze the cases with infection, and the presence of scattered items at the care scene. After the discussion and analysis with a group of experts, we proposed innovative strategies including the implementation of peripherally inserted central catheters (PICC) placement, provision of antimicrobial wound dressing with chlorhexidine gluconate, development of case analysis system, deployment of a dedicated cart for central line placement, prolongation of infusion time β-lactams, and revision of process for the removal of the central line. After the implementation of these strategies, the CLABSI incidence was reduced to 5.0‰ in the first three quarters of 2018, which were all reached the target level below 7.0‰. Therefore, hoping for generalization, we recommend a spreading of these strategies to other critical care units to enhance the quality of care. |