Medical and Health Sciences

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https://hdl.handle.net/20.500.11888/18295

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Browsing Medical and Health Sciences by Author "Awad, Safa"

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    THE IMPACT OF THE PROTOCOL CENTRAL LINE BUNDLE CARE ON CATHETER RELATED BLOOD STREAM INFECTION
    (An-Najah National University, 2024-09-10) Awad, Safa
    Background: Currently, there is a need to reduce central line-associated bloodstream infections (CLABSIs). The aim of this study was to determine whether the implementation of the evidence-based guideline-based care bundle protocol while applying and managing central venous catheters can reduce CLABSIs among intensive care unit patients in a Palestinian hospital. Methods: The study utilized a quasi-experimental design. This design used retrospective and prospective approaches. The CLABSIs that occurred before the implementation of the evidence-based guideline-based care bundle protocol were collected retrospectively during a 12-month period (Control period: January 2022 to December 2022). The CLABSIs that were detected after Implementing the evidence-based guideline-based care bundle protocol were collected prospectively over a 12-month period (Intervention period: January 2023 to December 2023). The site of the study was an adult intensive care unit in the southern region area of the West Bank of Palestine. Results: The study included 354 intensive care unit patients. Of those, 177 (50%) were in the control period and 177 (50%) were included in the intervention period. The adherence to the bundle care protocol was usually good, with most components ranging from 85.9% to 89.8%. The WBC count of the patients in the control period was significantly higher than that of the patients in the intervention period (p value < 0.001). Similarly, the percentage of monocytes of the patients in the control period was significantly higher than that of the patients in the intervention period (p value = 0.027). Moreover, the percentage of lymphocytes of the patients in the control period was significantly higher than that of the patients in the intervention period (p value < 0.001). The CRP values of the patients in the control period were significantly higher than those of the patients in the intervention period (p value = 0.010). There was a statistically significant higher incidence of CLABSIs before implementing the bundle care protocol (control period) (n = 71, 40.1%) compared to the period after implementing the bundle care protocol (intervention period) (n = 41, 23.2%) (p < 0.001). Although there was a difference in the mortality rates between the period before implementing the bundle care protocol (n = 45, 25.4%) compared to the period after implementing the bundle care protocol (n = 33, 18.6%), however, this difference was not statistically significant (p = 0.158). Conclusions: The results of this study showed that the use of the evidence-based guideline-based care bundle protocol significantly decreased the occurrence of CLABSIs in patients in the intensive care unit. Although compliance with the majority of aspects of the protocol was excellent, further efforts to improve adherence to daily line necessity evaluations should further optimize patient outcomes. Future research should prioritize investigating methods to maintain consistently high rates of adherence and examine the enduring effects of these regimens on patient morbidity and death. Keywords: Bundle, Central venous catheter, Blood stream infection, Central line-associated bloodstream infections, Intensive care unit, Nurses