ORIGINAL ARTICLEUse of Central Venous Catheter-Related Bloodstream Infection Prevention Practices by US Hospitals
Section snippets
Data Collection
Between March 16, 2005, and August 1, 2005, questionnaires were mailed to infection control coordinators at 719 hospitals across the United States.41 If the hospital employed more than 1 infection control professional (ICP), the one who supervised the other ICPs was asked to complete the survey. The 2005 American Hospital Association (AHA) database (fiscal year 2003 data) was used both to identify nonfederal, general medical, and surgical hospitals with more than 50 beds and with intensive care
RESULTS
The overall survey response rate was 72% (n=516), with 80% (n=95) of VA and 70% (n=421) of non-VA hospitals responding. Table 1 provides a comparison of the VA and non-VA hospitals across a number of characteristics. While the average number of ICU beds, evidence-based practice support score, use of hospitalists, and participation in an infection-related collaborative were similar for both, VA hospitals had a higher registered nurse staffing ratio, were more likely to be located in a
DISCUSSION
Evidence-based guidelines and recommendations have been published on how to reduce the risk of CR-BSIs, but often changes in practice lag behind guideline dissemination. In this case, however, our results suggest that a substantial proportion of US hospitals are following guideline recommendations and using 2 of the most strongly advocated practices: maximal sterile barrier precautions and chlorhexidine gluconate for insertion site antisepsis. Antimicrobial catheters are used by a smaller but
CONCLUSION
Our results have important implications for enhancing the safety of hospitalized patients.53, 54 Although many US acute care hospitals are following guidelines and using specific recommended practices for preventing CR-BSIs, fewer than half of non-VA US hospitals are concurrently using the 3 practices widely recommended to prevent CR-BSIs. To improve adoption of key CR-BSI prevention practices, hospitals can begin by fostering a culture of safety, encouraging ICP certification in infection
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This project was supported by the Department of Veterans Affairs, Health Services Research and Development Service (SAF 04-031) and the Ann Arbor VAMC/University of Michigan Patient Safety Enhancement Program. Dr Saint is supported by a VA Advanced Career Development Award.
The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs.