Comprehensive unit-based safety program for the prevention of central line-associated bloodstream infection

The growing use of peripherally inserted central catheters (PICCs) has led to an increased risk of central line-associated bloodstream infection (CLABSI), necessitating the development of strategies to address this issue. This study evaluated the implementation of a Comprehensive Unit-Based Safety Program (CUSP) for the reduction of CLABSI at a medical imaging department in a tertiary teaching hospital. The three CUSP phases included P1: baseline (October 2019 to June 2020), P2: implementation (July 2020 to March 2021), P3a and P3b: sustaining (April 2021 to December 2022). The CUSP followed by a technical intervention; silver-alginate-coated dressings were applied from April to December 2022 (P3b). All PICCs from a surgical ward were included. CLABSI rates were measured quarterly. The device utilization ratio was calculated by dividing the number of device days by patient days. A total of 213 PICCs were included. CLABSI rates decreased from 3.3 per 1,000 central line days (P1) to 2.7 (P2), then increased to 4.5 (P3a) but reduced the rate significantly to 1.8 (P3b) (rate ratio, 0.55; 95% confidence interval [CI], 0.29-0.99, p<0.05) and 0.9 per 1,000 patient days (rate ratio, 0.86; 95% CI, 0.64-1.16, p=0.31) following the introduction of silver-alginate-coated dressings. The device utilization ratio increased by 60%. The CUSP intervention led to a reduction rate of 45% overall. The introduction of CUSP led to decreased CLABSI following a technical intervention in the medical imaging department with sustainable improvements.