Effectiveness Of A Central Line Bundle In Prevention Of Central Venous Catheter Related Bloodstream Infections In Neurological Intensive Care Unit

Objective:To study a a central line bundle in prevention of central venous cathetercatheter related bloodstream infections(CRBSI) in Neurological intensive careunit(NICU).Methods:We used a total of296patients in NICU who were inserted central venouscatheter(CVC) from August2012to August2014as the research object;andchoose CVC insertion patients implementing routine nursing care betweenAugust2012and July2013as control group, CVC insertion patientsimplementing CLB from September2013to August2014as the CLB group; Toobserve the effectiveness of the implemention of a CLB,data of two groupswere compared.Results:1、There was19CRBSI infected cases in Control group, the incidence ofCRBSI was8.54‰, the occurrence time of CRBSI was11.42±3.78;There was7CRBSI infected cases in CLB group,the incidence of CRBSI was2.84‰, theoccurrence time of CRBSI was16.86±5.64; the incidence of CRBSI in CLBgroup was significantly lower than that in control group，the occurrence time of CRBSI was significantly later than that in control group（P＜0.01）.2、The rate of subclavian vein catheterization in CLB group was higherthan the control group, increased from40.4%to59.6%, while the rate offemoral vein catheterization is lower than the control group, from35.2%to22.7%, the statistical analysis indicated that the difference between the CLBgroup and the control group was statistically significance（P＜0.05）.3、 When CVC retention time less than or equal to7days, the differencein the incidence of CRBSI between the CLB group and the control group hadno statistical significance (P＞0.05);When CVC retention time more than7days, the incidence of CRBSI was15.31%,control group was5.17%, thedifference in the incidence of CRBSI between the CLB group and the controlgroup was statistically significance(P＜0.05), the incidence of CRBSI in CLBgroup was significantly lower than that in control group.4、For the two group patients with parenteral nutrition,the difference in theincidence of CRBSI was statistically significance(P＜0.05),the incidence ofCRBSI in CLB group was significantly lower than that in control group,from35.48%to5.41%.5、For the two group patients with hypoproteinemia,the difference in theincidence of CRBSI was statistically significance(P＜0.01),the incidence ofCRBSI in CLB group was significantly lower than that in control group,from34.21%to9.3%.6、For the two group patients with undergoing mechanical ventilation,the difference in the incidence of CRBSI was statistically significance(P＜0.01),the incidence of CRBSI in CLB group was significantly lower than that incontrol group,from24.59%to7.89%.Conclusions:1、The effect of clinical application of central line bundle in NICU wasbetter than the routine nursing intervention strategies, it can significantlyreduced the incidence of CRBSI, and delay the onset of CRBSI time.2、Clinical application of CLB significantly reduces the risk of CRBSI inpatients with the long-term CVC catheterization （＞7d）， parenteralnutrition,hypoalbuminemia and mechanical ventilation.