Assessment of Compliance with Bundle Programs for the Prevention of Bloodstream Infections

Abstract

Introduction: Bloodstream infections are a significant public health problem in hospitals, leading to increased hospital stays, costs, mortality, and morbidity. This study aims to evaluate compliance with the National Healthcare-Associated Infections Prevention Bundle Guidelines, published in March 2021. Materials and Methods: This study was conducted as a multicenter research between August and September 2022, involving physicians and nurses providing services in adult, pediatric, and neonatal intensive care units. Surveys were administered to collect data on participants’ demographic information, professional experiences, and practices related to catheter insertion and care. Results: The study included 156 nurses and 81 physicians from 24 different centers. Among the participating physicians, 41 were female, with an average age of 36.4 ± 9.1 years. It was observed that physicians had a compliance rate of 95% for hand hygiene before catheter insertion and 100% for using sterile gloves. The utilization rates for masks, sterile gowns, and caps were found to be 95%, 72.8%, and 56%, respectively. It was noted that a sterile full-body drape was used in 81% of cases. For skin antisepsis, 75.3% of physicians used povidone-iodine, 13.6% used chlorhexidine, 9.9% used povidone-iodine/alcohol, and 1.2% used chlorhexidine/ alcohol. Additionally, 76.5% of physicians reported waiting for the antiseptic to dry, while 19.9% stated that they would continue with the procedure despite being warned about the inadequate maintenance of sterility during the process. In the study, 136 (87.2%) of the participating nurses were female, with an average age of 31.7 ± 7.6 years. Hand hygiene compliance before catheter contact was 96.8%, while it was 99.4% after contact. 94.9% of the participants reported providing disinfection before touching the catheter, and 90.4% stated they performed disinfection after contact. The usage rate of checklists during catheter insertion was 87.2%, and during catheter care, it was 86.5%. 28 (34.6%) of the physicians and 74 (47.4%) of the nurses reported receiving training on bloodstream infection prevention bundles within the last year. Conclusion: The National Healthcare-Associated Infections Prevention Bundle Guidelines are an important step to reduce hospital infections in our country. Nevertheless, there is an observed lack of standardization across different hospitals in the implementation of these guidelines. It is believed that integrating bundle practices into routine applications and promoting behavioral changes can lead to improvements in infection rates in our country.

Keywords

• bundle programs
• bloodstream infections
• healthcare-associated infections
• infection control measures