Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic

Authors

  • Jose Manuel Martinez Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Luís Leite Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Daniela França Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Rita Capela Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Luísa Viterbo Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Natalina Varajão Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Ângelo Martins Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Isabel Oliveira Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Nélson Domingues Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Ilídia Moreira Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Ana Santo Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Filipe Trigo Microbiology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.
  • Jose Mariz Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

DOI:

https://doi.org/10.20344/amp.6002

Keywords:

Catheter-Related Infections, Catheterization, Central Venous, Neutropenia.

Abstract

Introduction: The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter.
Material and Methods: This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study.
Results: A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p < 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p < 0.014]. No significant difference (p > 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (< 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)].
Conclusions: The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.

Downloads

Download data is not yet available.

Author Biographies

Jose Manuel Martinez, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Enfermeiro Especialista unidade de oncohematologia

Luís Leite, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista STMO

Daniela França, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Enfermeira unidade oncohematologia

Rita Capela, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Enfermeira unidade Oncohematologia

Luísa Viterbo, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista Oncohematologia

Natalina Varajão, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Enfermeira oncohematologia

Ângelo Martins, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista

Isabel Oliveira, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista

Nélson Domingues, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista

Ilídia Moreira, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista

Ana Santo, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Medico Especialista

Filipe Trigo, Microbiology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Director Clinico deparatamento de Microbiologia

Jose Mariz, Hematology Oncology Unit. Instituto Português de Oncologia Francisco Gentil. Porto. Portugal.

Director Clinico Unidade Oncohematologia

Downloads

Published

2015-07-10

How to Cite

1.
Martinez JM, Leite L, França D, Capela R, Viterbo L, Varajão N, Martins Ângelo, Oliveira I, Domingues N, Moreira I, Santo A, Trigo F, Mariz J. Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic. Acta Med Port [Internet]. 2015 Jul. 10 [cited 2024 Mar. 29];28(4):474-9. Available from: https://www.actamedicaportuguesa.com/revista/index.php/amp/article/view/6002