The quality improvement of central venous catheter associated blood stream infection (CABSI) by new clinical practice guideline in pediatric ICU Siriraj Hospital.

ABSTRACT

Objective: To evaluate the effect of a new clinical practice guideline (CPG) in central venous catheter care to prevent catheter-associated bloodstream infection (CABSI) in pediatric intensive care units at Siriraj Hospital. Methods: Nonrandomized pre/post observational trial. The new clinical practice guideline in central venous catheter usage was given for a 6 month period from April to October 2003 The impact of CPG was observed by measurement of CABSI rate per 1,000 catheter days, over a 6 months period of pre/post CPG in two Pediatric Intensive Care Units. Results: Before the CPG implementation, the average CABSI rate of both PICUs was 15 episodes per 1,000 catheter days. After the CPG, the rates of CABSI in both units were markedly reduced. One unit was reduced to 3.8 episodes per 1000 catheter days and another unit had a 6 month CABSI free period. Conclusion: The new CPG in central venous catheter (CVC) care was excellent. It facilitated not only the medical personnel carrying out the CVC such as to make it easier to understand and reduce the variation of practice, but also it can improve the quality of care.