Impact of a multimodal intervention to reduce bloodstream infections related to vascular catheters in non-ICU wards: a multicentre study

Clin Microbiol Infect. 2013 Sep;19(9):838-44. doi: 10.1111/1469-0691.12049. Epub 2012 Nov 6.


To determine the impact of a multimodal intervention designed to reduce the incidence of catheter-related bloodstream infections (CRBSIs) outside the ICU, we conducted a prospective, quasi-experimental, before-after intervention study in 11 hospitals participating in the VINCat programme in Catalonia, Spain. The intervention consists of: (i) an evidence-based bundle of practices relating to catheter insertion and maintenance; (ii) a training programme for healthcare workers; (iii) four point-prevalence surveys to track the status of the catheters; and (iv) feedback reports to the staff involved. The study included both central (CVC) and peripheral venous catheters (PVCs). Rates of CRBSI per 1000 patient-days were prospectively measured in 2009 (pre-intervention period) and 2010 (post-intervention period). The analysis included 1 191 843 patient-days in 2009 and 1 173 672 patient-days in 2010. The overall incidence of CRBSI decreased from 0.19 to 0.15 (p 0.04) and the incidence of CRBSI associated with a CVC decreased from 0.14 to 0.10 (p 0.004) after the intervention. The incidence in PVCs remained unchanged. There was a statistically significant improvement in the adequate maintenance of both CVCs and PVCs. Among the CRBSIs originating in PVCs, 61.8% appeared more than 72 h every insertion. There was a lower infection rate in the hospitals with a higher adherence to the recommendation to replace PVCs after 72 h. Our findings suggest that the implementation of intervention programmes similar to ours could have a major impact on patient safety by reducing the incidence of CRBSIs, and that routine replacement of PVCs might additionally prevent a significant number of bloodstream infections.

Keywords: Catheter-related bloodstream infection; Staphylococcus aureus; central venous catheters; multimodal intervention; nosocomial bacteraemia; peripheral venous catheters.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / microbiology
  • Bacteremia / prevention & control*
  • Catheter-Related Infections / epidemiology
  • Catheter-Related Infections / microbiology*
  • Catheter-Related Infections / prevention & control*
  • Catheterization, Central Venous
  • Catheterization, Peripheral
  • Cross Infection / epidemiology
  • Cross Infection / microbiology
  • Cross Infection / prevention & control*
  • Fungemia / epidemiology
  • Fungemia / microbiology
  • Fungemia / prevention & control*
  • Humans
  • Infection Control / methods*
  • Prospective Studies
  • Risk Factors
  • Spain / epidemiology