P991 - AN INTEGRATED APPROACH TO REDUCE CATHETER-RELATED BLOODSTREAM INFECTIONS IN HPN PATIENTS

P991

AN INTEGRATED APPROACH TO REDUCE CATHETER-RELATED BLOODSTREAM INFECTIONS IN HPN PATIENTS

S. Sevela^1,*, F. Novak¹, P. Waldauf², K. Koudelkova³, J. Gojda³

¹4th department of internal medicine, General University Hospital, ²Department of Anaesthesia and Intensive Care Medicine 3FM CU and UHKV, ³Department of Internal Medicine 3FM CU and UHKV, University Hospital Kralovske Vinohrady, Prague, Czech Republic

Rationale: Long-term central venous access devices (CVAD) are essential for home parenteral nutrition (HPN) in patients with intestinal failure.  In this observational study, we tracked the incidence of CVAD-related complications over time evaluating the effectiveness of newly implemented measures in CVAD care such as antiseptic lock solutions and antiseptic barrier caps.

Methods: We retrospectively collected data from HPN patient registry across three distinct periods: the baseline period before 2012, the second period following systematic education of home care nurses in CVAD management, and the third period after implementation of comprehensive CVAD care improvements including aseptic locking solutions and barrier caps. We evaluated catheter-related bloodstream infections (CRBSI). Mean incidence rates and standard deviations were calculated for each subsequent period.

Results: The mean incidence rate and standard deviation of CRBSI in baseline period was 0.95 ± 0.47 CRBSI per 1000 catheter days in the first period, in the second period 0.25 ± 0.15 after systematic education of patients and caregivers, and in the third period 0.125 ± 0.18 after introduction of aseptic locking solutions and barrier caps respectively. This demonstrates a consistent downward trend in infection rates across periods, with the highest variability in the first period and the lowest in the second period.

Conclusion: Our study demonstrates a reduction in catheter-related infections among HPN patients across the three observation periods. These findings suggest that an integrated approach combining strict adherence to catheter care techniques including targeted caregiver education together with modern technological solutions may be effective in reducing the risk of infectious complications associated with long-term CVAD in HPN patients. Prospective intervention

studies are required.

Disclosure of Interest: None declared