Effect of a five-year practice of multidimensional evidence-based interventions on reduction of incidence of central line-associated bloodstream infections in intensive care units of pediatrics department
10.11816/cn.ni.2025-250375
- VernacularTitle:多维度循证干预降低儿科重症监护病房中心静脉导管相关血流感染发生率的五年实践与效果评价
- Author:
Linjuan WANG
1
;
Min ZHOU
;
Liting ZENG
;
Hongtao JIA
;
Qi DONG
;
Weike MA
;
Fangfang LIANG
Author Information
1. 深圳市儿童医院重症医学科,广东 深圳 518026
- Publication Type:Journal Article
- Keywords:
Critically ill child;
Central venous catheter;
Catheter-associated bloodstream infection;
Quality control;
Control chart
- From:
Chinese Journal of Nosocomiology
2025;35(18):2791-2795
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVE T o explore the long-term effect of multidimensional evidence-based interventions based on i-PARIHS theoretical framework on reduction of incidence of central line-associated bloodstream infections(CLABSI)in pediatric intensive care units(PICU)of pediatrics department and evaluate the impact on nurses'compliance to taking the interventions and use intensity of catheters.METHODS By means of quasi-experimental design,the multidimensional intervention system covering multidisciplinary collaboration,standardized operation procedures,information system optimization and hierarchical training was established and staged for implementa-tion of 5 years(from T0 baseline stage to T3 maintenance stage).The variations in implementation rates of cathe-ter maintenance(daily maintenance,dressings change,catheter removal)were analyzed by Chi-square test,and the change of incidence of CLABSI was monitored with the use of statistical process control U chart.RESULTS The nurses'compliance to operations was remarkably improved(P＜0.05)o The implementation rate of dressings change continuously increased from 52.91％in T0 to81.62％in T3(x2=72.444,P＜0.001),the implementa-tion rate of catheter removal increased from 48.72％to 79.31％(x2=8.179,P=0.042).The incidence rate of CLABSI decreased from 1.92％0 in 2019 to 0.5％0 in 2022,and the control chart showed that most of the months fluctuated within control limits.CONCLUSIONS The multidimensional evidence-based interventions can achieve a long term control of CLABSI by raising the nurses' compliance to operations.The information monitoring and closed-loop management are crucial to maintenance of the interventional effect,and the risk early warning system should be optimized with the combination of artificial intelligence technology.
