VA tops private hospitals in infection-con...( ANN ARBOR MI Department ...),Health

ANN ARBOR, MI Department of Veterans Affairs (VA) medical centers are more likely than non-VA hospitals to follow recommendations for preventing bloodstream infections associated with central venous catheters, says a survey of more than 500 U.S. health care centers. The results appear in the June issue of Mayo Clinic Proceedings.

The recommendations were published by the Agency for Healthcare Research and Quality in 2001, and by the Centers for Disease Control in 2002. Since then, "There really had not been any national studies that had looked at whether hospitals were following the recommendations," said Sarah Krein, PhD, a research health scientist with the Center for Practice Management and Outcomes Research at the VA Ann Arbor Healthcare System, and a research assistant professor at the University of Michigan.

The recommendations include:

• Maximal sterile barrier precautions for inserting a central venous catheter. This includes sterile gloves and gown, mask, cap, and a large sterile drape

• Chlorhexidine gluconate (2 percent) on the skin as an antiseptic before insertion, rather than povidone iodine or alcohol

• Replacing catheters as needed, rather than every 4 to 7 days

• Using antimicrobial catheters, but only if other precautions do not reduce infection rates

Krein and colleagues completed a survey of 95 VA and 421 non-VA hospitals between March 16 and August 1, 2005. "Regular use" refers to always, or almost always, using a procedure.

Most hospitals reported regular use of maximal sterile barrier precautions (MSB) to prevent infection: 84 percent of VA hospitals and 71 percent of non-VA hospitals. Ninety-one percent of VA hospitals regularly used chlorhexidine gluconate as an antiseptic, compared with 69 percent of non-VA hospitals.

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Contact: Cathy Kerr
cathy.kerr@va.gov
734-761-5458
Veterans Affairs Research
1-Jun-2007