A Multifaceted Intervention Program to Prevent Bloodstream Infection in an IntensiveCare Unit Running Head: An Intervention for the Reductionof Bacteraemia in ICU

Objective: Bloodstream infections (BSIs) are associated with increased morbidity and mortality among critically ill patients. The aim of this prospective multifaceted interventional study is to investigate the effect of a bundle of measures on BSI rates. Methods: The study was divided in a baseline and an intervention period. The interventions initiated consisted of a central venous catheter (CVC) insertion and maintenance bundle, an educational program promoting hand hygiene among health-care workers as well as weekly performance feedback. Patient data collected included demographics, days of antimicrobial therapy and CVC catheterizations and episodes of bacteraemia. Altogether, 267 patients were enrolled in the study. Results: Bacteraemia occurred in 35 out of 143 patients in the baseline period (14.7 incidents per 1000 patient-days) and in 18 out of 124 patients in the intervention period (8.8 incidents per 1000 patient-days). This indicates a statistically significant lower BSI incidence after implementing the intervention (p < 0.05, OR 1.9). Conclusions: An intervention program including modifying CVC insertion and maintenance as well as promoting hand hygiene seems to be an effective way of preventing BSI in intensive care units.