Four nurses trained in observation will unobtrusively observe staff when they apply the insertion and maintenance bundles.
Fifth, feedback: quarterly reporting of the CA-BSI incidence and the rates of adherence to the insertion and maintenance bundles.
We will test the following hypothesis: implementation of hospital-wide CVC insertion and maintenance bundles on the guidance of the Pronovost-model promotes protocol adherence and reduces the number of CA-BSIs.
The baseline rates of adherence to the insertion and maintenance bundles are estimated at 60%and20%0%, respectively; the post intervention rates aimed at are 100%and45%5%, respectively.
There is growing evidence that a combination of interventions, termed CVC insertion and maintenance bundles, may be effective in preventing CA-BSIs in infants and children as well [ 9, 13- 15].
Only two thirds of hospitals have implemented insertion and maintenance bundles, and less than half monitor compliance to preventive measures, despite their reported effectiveness in decreasing CLABSI incidence rates [ 3- 8].
The occurrence of MC-CRBSI can be decreased by implementing and adhering to central line insertion and maintenance bundles, strictly following hand hygiene procedures, as well as environmental decontamination, not only to prevent CRIs, but to limit the spread of multidrug-resistant bacteria.
