Preventive strategies for the reduction of central line-associated bloodstream infections in adult intensive care units: A systematic review

• Published in: Collegian (Royal College of Nursing, Australia) Vol. 28; no. 4; pp. 438 - 446
• Main Authors: Alanazi, Tariq Noman M., Alharbi, Khalid Abdullah S., Alrawaili, Adel Basha R., Arishi, Amal Awaji M.
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.08.2021
• Subjects: Adult patient; Central line-associated bloodstream infection; Intensive care unit; Prevention; Reduction; Prevention; Adult patient; Central line-associated bloodstream infection; Reduction; Intensive care unit
• ISSN: 1322-7696
• DOI: 10.1016/j.colegn.2020.12.001

The use of central lines (CLs) is essential for adult patients admitted in intensive care units (ICUs). However, CLs increase the risk of central line-associated bloodstream infections (CLABSIs). This systematic review aimed to explore and identify all existing evidence-based interventions to prevent and/or reduce CLABSIs in adult ICUs. A systematic review of related studies published from January 2016 to June 2020 was carried out. The databases of Web of Science, CINAHL Plus with Full Text, MEDLINE Complete, Scopus, and Science Direct were systematically searched. All studies were evaluated in accordance with the established inclusion and exclusion criteria and appraised by the researchers independently. Fifteen studies were included after the quality evaluation of full-text studies. The selected studies investigated several evidence-based interventions to prevent and/or reduce CLABSI rates that were consistent with and added to a previous systematic review. These interventions included compliance with and improvement of CL bundle implementation using checklists before and after CL insertion, chlorhexidine and silver-plated dressings, infection control and multidisciplinary intervention through real-time bedside monitoring, use of positive displacement needleless connectors, and mandatory reporting laws on CLABSIs. Evidence-based findings showed that a zero CLABSI rate was achievable with the use of positive displacement needleless connectors. Other additional interventions that could reduce CLABSI rates include checklist placement and monitoring of the CL care bundle, use of silver-plated dressings, constant education of ICU personnel, regular real-time bedside monitoring, and mandatory reporting of CLABSIs.