Abstract
back(56) Evaluation of the Central Line Care Bundle for Hospitalized Oncology and Haematology-Oncology Patients in Reducing Central Line Associated Bloodstream Infection (CLABSI) in a Local Oncology Unit
Mr. Tak-Kei LIU1, Ms. Sheung-Ling CHAN1, Ms. So-Shan MAK1, Mr. Wai-Man WAN1, Ms. Yuk-King HUNG1, Mr. Ka-Fai WONG1, Mr. Kim-Hung LEE1
1Prince Of Wales Hospital, Hong Kong SAR
Background
Oncology and haematology-oncology patients are at risk of CLABSI due to patients’ severe immunosuppressed status relating to the disease or treatment side effect. CLABSI results in lengthened hospitalization, increased mortality and health cost. Therefore, a central line care bundle has been implemented since 2014 in a local oncology unit to promote good practice and reduce CLABSI.
Objectives
To evaluate the effectiveness of the central line care bundle in reducing CLABSI rate for hospitalized oncology and haematology-oncology patients, and to outline the epidemiology of CLABSI and patients’ outcome.
Methodology
This is a retrospective review of the CLABSI rate and positive cases. Medical record and CLABSI data from infection control team (ICT) in a local oncology unit was accessed for the period before and after the implementation of central line care bundle (from 2013 to 2019). The central line care bundle consists of a serial of improvement cycles including patient education, staff training, practice guideline review, staff competence assessment, audit and a joint-unit surveillance programme.
Result
The CLABSI rate decreased significantly after implementation of central line care bundle, from 8.48 per 1000 central line days in 2013 to 3.4, 5.8, 2.36, 2.87, 2.53 and 4.66 per 1000 central line days from 2014 to 2019 respectively. The overall incidence rate ratio was 0.43 with 57% of reduction after the starting of care bundle. However, due to the limitation of data set, record before 2013 was not accessible. Among those CLABSI cases, gram-negative pathogens were more common (69% of all CLABSI) and E. coli was the most common pathogen (8% of all CLABSI).
Conclusion
The central line care bundle was effective in reducing CLABSI for oncology and haematology-oncology patients. Further review in the common pathogen and sources of infection is needed to keep improvement of the CLABSI.