IMPACT OF AN EDUCATIONAL-PROGRAM FOR THE PREVENTION OF COLONIZATION OF INTRAVASCULAR CATHETERS

OBJECTIVE: To evaluate the efficacy of an educational program for the prevention of catheter colonization. DESIGN: Two cross-sectional studi es were carried out in a 500-bed randomly selected area of the hospita l, separated by an educational program on the care of intravenous line s based on the Centers for Disease Control and Prevention (CDC) recomm endations for the control of catheter-related infections. SETTING: A 2 ,100-bed urban general hospital affiliated with the University of Madr id (Spain). METHODS: Characteristics of patients and catheters and app ropriateness of catheter care were evaluated. Cultures were taken from the point of insertion of the vascular catheter, the hubs, and infusi on fluids. When catheter-associated infection was suspected, the dista l end of the catheter was sent for culture and two blood cultures were taken. We compared the clinical and microbiological data before and a fter carrying out an educational program based on CDC recommendations for the control of catheter-related infections. RESULTS: Characteristi cs of patients and catheters did not differ between the two cross-sect ional studies. Compared with baseline data, after the educational prog ram we observed a reduction of inappropriate catheter care, from 83% t o 38% (45% difference, 95% confidence interval [CI95], 55% to 35%, P<0 .0000), and a reduction in Che rate of skin colonization, from 34% to 18% (16% difference, CI95, 26% to 5%, P<0.001). The frequency of phleb itis (15% versus 14%), hub colonizations (12% versus 11%), catheter co lonizations (2% versus 1%), and catheter-related bacteremias (0% versu s 0%) remained unchanged between the two cross-sectional studies. CONC LUSIONS: Our educational program improved catheter care and reduced si gnificantly the proportion of skin colonization around the insertion p oint. However, the educational program did not modify the proportion o f hub colonization; because hub colonization has been demonstrated to be a source of line sepsis, our data suggest the need for a specific p rogram directed to the maintenance of catheter hubs (Infect Control Ho sp Epidemiol 1994;15:239-242).