Table 1 Description of the central line infection control program
| Â | Baseline | Phase 1 (March 2011 -August 2011) | Phase 2 (September 2011-February 2012) | Phase 3 (March 2012 -September 2012) |
|---|---|---|---|---|
Care process | 1. Appropriate hand hygiene before and after any CVC care | As baseline | As baseline | As baseline |
2. Use of maximal barrier precautions and skin antisepsis (0.5% chlorhexidine in 70% alcohol or alcoholic povidone-iodine) before CVC insertion | ||||
3. Replacement of gauze dressing every 24Â hours or when damp, loose, or visibly soiled replacement of transparent dressings every 7Â days or when damp, loose, or visibly soiled | ||||
4. Disinfection of catheter hubs and injection ports before they are accessed with an appropriate antiseptic (chlorhexidine in 70% alcohol or 70% alcohol) | ||||
5. Traceability of information about CVC, dressing and lines (dating of placement) | ||||
Monitoring of outcome measures | None | CLABSI/1,000 CVC-days, CVC utilization ratio | CLABSI/1,000 CVC-days, CVC utilization ratio | CLABSI/1,000 CVC-days, CVC utilization ratio |
Monitoring of process measures | Â | Â | Â | Â |
Type of insertion site | None | Point prevalence survey of type of insertion site (internal jugular, subclavian, or femoral veins) | Point prevalence survey of type of insertion site as in phase 1 | Point prevalence survey of type of insertion site as in phase 1 |
Care process | None | None | Monitoring of 5 CVC care process. Compliance rate with each care process was calculated by dividing the number of actions performed by the number of appropriate actions, expressed as a percentage | None |
Staff meetings | Two meetings of study information and staff education per ICU | None | Monthly meeting with ICU staff to report outcome and process indicators | None |
Feedback reports | None | None | Monthly feedback reports of outcome and process indicators posted in each ICU by the study investigator | Monthly feedback of outcome indicators sent via e-mail to ICU leaders Feedback posted in the ICU at the ICU leaders’ discretion |