Are CVAD bundles effective in preventing CLABSI?

A systematic review and meta-analysis (Ista et al, 2016) aimed to quantify the effectiveness of central-line bundles (insertion or maintenance or both) to prevent CLABSI in ICU patients. In the meta-analysis the incidence of infections decreased significantly from median 6·4 per 1000 catheter-days (IQR 3·810·9) to 2·5 per 1000 catheter-days (1·44·8) after implementation of bundles (IRR 0·44, 95% CI 0·390·50, p<0·0001; I2=89%). Implementation of central-line bundles has the potential to reduce the incidence of CLABSIs in ICU patients.

Zingg and Pittet (2016) caution that success frequently relies on adaption of the strategy to the local context; therefore, it is important to understand the complexity of an innovation and culture of a setting. Bundles prevent central-line infections, but their successful implementation needs multimodal approaches adapted to local realities. 

References:

Ista E, van der Hoven B, Kornelisse R, et al. Effectiveness of insertion and maintenance bundles to prevent central-line-associated bloodstream infections in critically ill patients of all ages: a systematic review and meta-analysis. The Lancet Infectious Diseases. Vol 16, No 6, 2016. DOI: 10.1016/S1473-3099(15)00409-0. 

Zingg W, Pittet D. Central-line bundles need a multimodal implementation strategy. The Lancet Infectious Diseases. Vol 16, No 6, 2016. DOI: 10.1016/S1473-3099(15)00480-6 

Last Updated on: 02/09/2020

Meet ASK IVY, your infusion therapy companion! Powered by AI and aligned with the Infusion Therapy Standards of Practice, 9th edition, ASK IVY is your go-to resource for answers to your clinical questions.

Clinicians can streamline their workflow, save time, and enhance patient care.

• INS members enjoy unlimited queries by logging in to the member portal below.
• All other users are limited to 10 per month.