Reduction of catheter-associated bloodstream infections: Effectiveness of the continuous quality improvement method at a university hospital in Colombia
Abstract
Introduction: Central Line-Associated Bloodstream Infections (CLABSI) are preventable and potential fatal events, frequent in critical patient care. By mid-2018 an increase was noted in the incidence rate of CLABSI at a high complexity institution in Colombia, demanding immediate interventions to lower those numbers.
Objective: To assess the effectiveness of the continuous quality improvement methodology (CQI) to lower the incidence rate of CLABSI at a university hospital in Bogotá, Colombia.
Methods: Longitudinal, prospective study implementing a multifaceted intervention in accordance with the CQI methodology. The project was developed at a high complexity university hospital in Bogotá, Colombia, between July 2018 and December 2019. A root cause analysis was consecutively conducted prioritizing contributing factors, gathering ideas for improvement, building a strategy and prioritizing the implementation plan.
Results: The CQI methodology enabled the identification of areas susceptible of catheter insertion and management errors at the institution; additionally, it allowed for the prioritization of the areas requiring intervention through consecutive test cycles for improvement ideas. The reduction and sustainability of insertion-related CLABSI was accomplished three months after the start of the interventions, achieving a zero value. The implementation of improvement ideas aimed at reducing the events associated with catheter maintenance was also able to reduce the incidence to zero, until the end of the period of observation of the study.
Conclusion: It is feasible to implement CQI in settings similar to the one herein described, in order to efficiently reduce CLABSIs.
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