Effects evaluation of multimodal interventions on reducing the incidence rate of vessel catheter associated infection_West China Medical Journal

Authors：

LIU Hourong ¹ ,  ZENG Jincai ² , HUANG Xuehuan ¹ , LIANG Baofang ¹

1. Office of Hospital Infection Management, the Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, Guangdong 523000, P. R. China;
2. Department of Preventive Healtht, the Tenth Affiliated Hospital of Southern Medical University (Dongguan People’s Hospital), Dongguan, Guangdong 523000, P. R. China;

Corresponding?author：

ZENG Jincai, Email: zengjincai@dgsrmyy10.wecom.work

Keywords：

Vessel catheter associated infection; intravascular catheter; multimodal interventions; incidence rate

DOI：

10.7507/1002-0179.202501166

Video：

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Objective To explore the effect of multimodal interventions in improving the compliance rate of core infection control measures on reducing the incidence rate of vessel catheter associated infection (VCAI). Methods Inpatients with intravascular catheters in 5 departments with high rates of vascular catheterization and infection of Dongguan People’s Hospital between January 2021 and December 2022 were selected. According to the hospital stay, patients were divided into a pre-intervention group (January to December 2021) and a post-intervention group (January to December 2022). The core infection control measures assessment pass rates of medical staff between the two periods and the differences in the incidence rate of VCAI, average catheterization days, and catheterization rate before and after intervention in both groups were compared. Results A total of 8174 patients were included. Among them, there were 3915 patients in the pre-intervention group and 4259 patients in the post-intervention group. In the pre-intervention group, the total length of hospital stay was 122885 days, the total number of catheterization days was 48028 days, and 28 cases of VCAI occurred. In the post-intervention group, the total length of hospital stay was 126966 days, the total number of catheterization days was 51253 days, and 12 cases of VCAI occurred. After intervention, the compliance rate of VCAI core infection control measures was improved [69.21% (2907/4200) vs. 91.24% (3832/4200); χ²=642.090, P＜0.001], the pass rate of medical staff’s core infection control measures assessment was improved [53.33% (128/240) vs. 91.67% (220/240); χ²=88.443, P＜0.001], the catheterization rate was increased [39.08% (48028/122885) vs. 40.37% (51253/126966); χ²=42.979, P<0.001], and the incidence rate of VCAI was reduced [0.58‰ (28/48028) vs. 0.23‰ (12/51253); incidence-rate ratios =0.40, 95% confidence interval (0.20, 0.79), P=0.008]. Conclusions Improving the compliance rate of VCAI core infection control measures through multimodal interventions can significantly improve the passing rates of core infection control measures of medical staffs. This will help to reduce the incidence of VCAI and ensuring patient safety, provide evidence-based support for the prevention and control of VCAI.

Citation： LIU Hourong, ZENG Jincai, HUANG Xuehuan, LIANG Baofang. Effects evaluation of multimodal interventions on reducing the incidence rate of vessel catheter associated infection. West China Medical Journal, 2025, 40(3): 377-382. doi: 10.7507/1002-0179.202501166 Copy

1.	Planes AM, Calleja R, Bernet A, et al. Evaluation of the usefulness of aquantitative blood culture in the diagnosis of catheter-related blood stream infection: comparative analysis of two periods (2002 and 2012). Enferm Infect Microbiol Clin, 2016, 34(8): 484-489.
2.	Buetti N, Ruckly S, Lucet JC, et al. Practice and intravascular catheter infection during on- and off- hours incritically ill patients. Ann Intensive Care, 2021, 11(1): 153.
3.	湯艷春, 姚春梅. 神經外科重癥監護病房患者發生血管內導管相關血流感染的危險因素分析. 護理實踐與研究, 2021, 18(13): 1920-1923.
4.	袁美嬌, 王春艷, 蔡學聯. 我國中心靜脈導管相關性血流感染研究的文獻計量學分析. 護士進修雜志, 2019, 34(7): 602-605, 667.
5.	Nakamura I, Fukushima S, Hayakawa T, at el. The additional costs of catheter-related bloodstream infections in intensive care units. Am J Infect Control, 2015, 43(10): 1046-1049.
6.	Liu H, Liu H, Deng J, et al. Preventing catheter-related bacteremia with taurolidine-citrate catheter locks: a systematic review and meta-analysis. Blood Purif, 2014, 37(3): 179-187.
7.	國家衛生健康委辦公廳醫政醫管局. 血管導管相關感染預防與控制指南(2021 版). 中國感染控制雜志, 2021, 20(4): 387-388.
8.	O’Grade NP, Alexander M, Burns LA, et al. Summary of recommendations: guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis, 2011, 52(9): 1087-1099.
9.	中華人民共和國國家衛生和計劃生育委員會. 重癥監護病房醫院感染預防與控制規范: WS/T509-2016. 北京: 中國標準出版社, 2017.
10.	中華人民共和國國家衛生和計劃生育委員會. 臨床微生物實驗室血培養操作規范: WS/T 503-2017. 北京: 中國標準出版社, 2017.
11.	Vanshi PG, Virginkar N, Popiel B, et al. Incidence of and factors associated with catheter related bloodstream infection in patients with advanced solid tumors on home parenteral nutrition managed using a standardized catheter care protocol. BMC Infect Dis, 2017, 17(1): 372.
12.	Tao FZ, Jiang R, Chen Y, et al. Risk factors for early onset of catheter-related bloodstream infection in an intensive care unit in China: a retrospective study. Med Sci Monit, 2015, 21: 550-556.
13.	Miliaraki M, Katzilakis N, Chranioti I, et al. Central line-associated bloodstream infection in childhood malignancy: single-center experience. Pediatr Int, 2017, 59(7): 769-775.
14.	Umscheid CA, Mitchell MD, Doshi JA, et al. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol, 2011, 32(2): 101-114.
15.	Gao Y, Liu Y, Ma X, et al. The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients. Ther Clin Risk Manag, 2015, 11: 863-871.
16.	張俏, 賈冰, 張曉慧, 等. 綜合干預措施在提高住院患者抗菌藥物治療前病原學送檢率中的效果評價. 中國實驗診斷學, 2025, 29(1): 61-66.
17.	曹煜隆, 單嬌, 龔志忠, 等. 中央導管相關血流感染管理成效序貫分析. 中國感染控制雜志, 2021, 20(9): 822-826.
18.	Tan CC, Zanariah Y, Lim KI, et al. Central venous catheter-related blood stream infections: incidence and analysis of risk factors. Med J Malaysia, 2007, 62(5): 370-374.
19.	Laupland KB, Koulenti D, Schwebel C. The CVC and CRBSI: don’t use it and lose it!. Intensive Care Med, 2018, 44(2): 238-240.
20.	van der Kooi T, Sax H, Pittet D, et al. Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster randomized multicentre study to reduce central venous catheter-related bloodstream infections. Intensive Care Med, 2018, 44(1): 48-60.van der Kooi T, Sax H, Pittet D, et al. Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster randomized multicentre study to reduce central venous catheter-related bloodstream infections. Intensive Care Med, 2018, 44(1): 48-60.
21.	曾翠, 李六億, 賈會學, 等. 重癥監護病房中央導管相關血流感染的干預研究. 中國感染控制雜志, 2015, 14(8): 535-539.
22.	杜學娜, 張巖, 董愛英, 等. 中心靜脈導管留置部位及時間與感染發生的相關性分析. 中國臨床醫生雜志, 2017, 45(1): 47-49.
23.	Hu KK, Veenstra DL, Lipsky PA, et al. Use of maximal sterile barriers during central venous catheter insertion: clinical and economic outcomes. Clin Infect Dis, 2004, 39(10): 1441-1445.
24.	張靜, 高曉東, 胡必杰, 等. 重癥監護病房醫護人員導管相關性血流感染現狀與預防控制措施認知的調查. 中華醫院感染學雜志, 2011, 21(12): 2411-2413.
25.	李蕓蕓, 余雪梅, 劉明秀. 外周靜脈置管導管相關性感染護理措施預防效果的系統評價. 中華現代護理雜志, 2016, 22(20): 2869-2872.
26.	李靜, 胡愛香, 張越巍, 等. 重點科室護士醫院感染防控知識水平調查. 中華現代護理雜志, 2019, 25(3): 357-359.

1. Planes AM, Calleja R, Bernet A, et al. Evaluation of the usefulness of aquantitative blood culture in the diagnosis of catheter-related blood stream infection: comparative analysis of two periods (2002 and 2012). Enferm Infect Microbiol Clin, 2016, 34(8): 484-489.
2. Buetti N, Ruckly S, Lucet JC, et al. Practice and intravascular catheter infection during on- and off- hours incritically ill patients. Ann Intensive Care, 2021, 11(1): 153.
3. 湯艷春, 姚春梅. 神經外科重癥監護病房患者發生血管內導管相關血流感染的危險因素分析. 護理實踐與研究, 2021, 18(13): 1920-1923.
4. 袁美嬌, 王春艷, 蔡學聯. 我國中心靜脈導管相關性血流感染研究的文獻計量學分析. 護士進修雜志, 2019, 34(7): 602-605, 667.
5. Nakamura I, Fukushima S, Hayakawa T, at el. The additional costs of catheter-related bloodstream infections in intensive care units. Am J Infect Control, 2015, 43(10): 1046-1049.
6. Liu H, Liu H, Deng J, et al. Preventing catheter-related bacteremia with taurolidine-citrate catheter locks: a systematic review and meta-analysis. Blood Purif, 2014, 37(3): 179-187.
7. 國家衛生健康委辦公廳醫政醫管局. 血管導管相關感染預防與控制指南(2021 版). 中國感染控制雜志, 2021, 20(4): 387-388.
8. O’Grade NP, Alexander M, Burns LA, et al. Summary of recommendations: guidelines for the prevention of intravascular catheter-related infections. Clin Infect Dis, 2011, 52(9): 1087-1099.
9. 中華人民共和國國家衛生和計劃生育委員會. 重癥監護病房醫院感染預防與控制規范: WS/T509-2016. 北京: 中國標準出版社, 2017.
10. 中華人民共和國國家衛生和計劃生育委員會. 臨床微生物實驗室血培養操作規范: WS/T 503-2017. 北京: 中國標準出版社, 2017.
11. Vanshi PG, Virginkar N, Popiel B, et al. Incidence of and factors associated with catheter related bloodstream infection in patients with advanced solid tumors on home parenteral nutrition managed using a standardized catheter care protocol. BMC Infect Dis, 2017, 17(1): 372.
12. Tao FZ, Jiang R, Chen Y, et al. Risk factors for early onset of catheter-related bloodstream infection in an intensive care unit in China: a retrospective study. Med Sci Monit, 2015, 21: 550-556.
13. Miliaraki M, Katzilakis N, Chranioti I, et al. Central line-associated bloodstream infection in childhood malignancy: single-center experience. Pediatr Int, 2017, 59(7): 769-775.
14. Umscheid CA, Mitchell MD, Doshi JA, et al. Estimating the proportion of healthcare-associated infections that are reasonably preventable and the related mortality and costs. Infect Control Hosp Epidemiol, 2011, 32(2): 101-114.
15. Gao Y, Liu Y, Ma X, et al. The incidence and risk factors of peripherally inserted central catheter-related infection among cancer patients. Ther Clin Risk Manag, 2015, 11: 863-871.
16. 張俏, 賈冰, 張曉慧, 等. 綜合干預措施在提高住院患者抗菌藥物治療前病原學送檢率中的效果評價. 中國實驗診斷學, 2025, 29(1): 61-66.
17. 曹煜隆, 單嬌, 龔志忠, 等. 中央導管相關血流感染管理成效序貫分析. 中國感染控制雜志, 2021, 20(9): 822-826.
18. Tan CC, Zanariah Y, Lim KI, et al. Central venous catheter-related blood stream infections: incidence and analysis of risk factors. Med J Malaysia, 2007, 62(5): 370-374.
19. Laupland KB, Koulenti D, Schwebel C. The CVC and CRBSI: don’t use it and lose it!. Intensive Care Med, 2018, 44(2): 238-240.
20. van der Kooi T, Sax H, Pittet D, et al. Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster randomized multicentre study to reduce central venous catheter-related bloodstream infections. Intensive Care Med, 2018, 44(1): 48-60.van der Kooi T, Sax H, Pittet D, et al. Prevention of hospital infections by intervention and training (PROHIBIT): results of a pan-European cluster randomized multicentre study to reduce central venous catheter-related bloodstream infections. Intensive Care Med, 2018, 44(1): 48-60.
21. 曾翠, 李六億, 賈會學, 等. 重癥監護病房中央導管相關血流感染的干預研究. 中國感染控制雜志, 2015, 14(8): 535-539.
22. 杜學娜, 張巖, 董愛英, 等. 中心靜脈導管留置部位及時間與感染發生的相關性分析. 中國臨床醫生雜志, 2017, 45(1): 47-49.
23. Hu KK, Veenstra DL, Lipsky PA, et al. Use of maximal sterile barriers during central venous catheter insertion: clinical and economic outcomes. Clin Infect Dis, 2004, 39(10): 1441-1445.
24. 張靜, 高曉東, 胡必杰, 等. 重癥監護病房醫護人員導管相關性血流感染現狀與預防控制措施認知的調查. 中華醫院感染學雜志, 2011, 21(12): 2411-2413.
25. 李蕓蕓, 余雪梅, 劉明秀. 外周靜脈置管導管相關性感染護理措施預防效果的系統評價. 中華現代護理雜志, 2016, 22(20): 2869-2872.
26. 李靜, 胡愛香, 張越巍, 等. 重點科室護士醫院感染防控知識水平調查. 中華現代護理雜志, 2019, 25(3): 357-359.

West China Medical Journal

Effects evaluation of multimodal interventions on reducing the incidence rate of vessel catheter associated infection

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