Infection control · Preventing catheter infection
An intervention to decrease catheter-related bloodstream infections in the ICU
| Design | Prospective cohort study with a collaborative quality-improvement intervention |
|---|---|
| Treatment | Five-element evidence-based catheter insertion and maintenance bundle |
| Control | Baseline period before the intervention |
| Population | 103 intensive care units contributing 1981 ICU-months and 375,757 catheter-days |
| Follow-up | 18 months |
| Primary endpoint | Rate of catheter-related bloodstream infection per 1000 catheter-days |
| Result | The intervention produced a large and sustained reduction of up to 66% in catheter-related bloodstream infection rates, maintained throughout the 18-month study period. |
| Secondary endpoints | Sustainability of the effect over time |
An evidence-based intervention resulted in a large and sustained reduction (up to 66%) in rates of catheter-related bloodstream infection that was maintained throughout the 18-month study period.
The trial authors, in the published abstract
The founding document of the ICU quality-improvement movement, and the reason catheter insertion checklists exist. It is a before-and-after study rather than a randomised trial, so secular trends cannot be excluded — but the effect size and durability have persuaded almost everyone.
Pronovost P, Needham D, Berenholtz S, et al. An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006 Dec 28;355(26):2725-32.