P1064 - REDUCING CATHETER-RELATED BLOODSTREAM INFECTION IN PARENTERAL NUTRITION PATIENTS: A QUALITY IMPROVEMENT PROJECT IN A LONDON PRIVATE HOSPITAL

P1064

REDUCING CATHETER-RELATED BLOODSTREAM INFECTION IN PARENTERAL NUTRITION PATIENTS: A QUALITY IMPROVEMENT PROJECT IN A LONDON PRIVATE HOSPITAL

N. Madrid^1,*

¹Princess Grace Hospital, London, United Kingdom

Rationale: Catheter-related bloodstream infection (CRBSI) is a significant complication associated with parenteral nutrition (PN), leading to increased morbidity and healthcare costs. This quality improvement (QI) project aimed to reduce the CRBSI rate of patients on PN by addressing the practices and competencies of nurses.

Methods: The methodology included a review of nursing practices through audits, stakeholder engagement, PN competency development, enhanced staff training, and ongoing evaluation of outcomes. Nurses completed a validated PN competency assessment before administering or disconnecting PN. Baseline CRBSI rates were retrospectively reviewed. Given ethical constraints, a control group was not feasible. CRBSI rates and confidence intervals were calculated using a one-sample proportion comparison.

Results: The baseline CRBSI rate was 5.46 per 1000 catheter days. Following the implementation of the QI initiative, the CRBSI rate was reassessed. Over the course of two years (2023–2024), 109 central lines were used for PN, accounting for a total of 5514 catheter days. During this period, three CRBSI cases were reported, resulting in a CRBSI rate of 0.54 per 1000 catheter days with a 95% confidence interval of 0.14 to 1.48 per 1000 catheter days. This represents a significant reduction from the baseline rate. By the end of 2024, nearly 90% of nursing staff in the surgical and medical wards had received training. Additionally, PN documentation compliance improved from 72.6% pre-intervention to 90.5% post-intervention.

Conclusion: Comprehensive education and standardized training for nurses administering PN are critical for effectively reducing CRBSI rates. By prioritizing these measures, hospitals can significantly enhance patient safety, improve clinical outcomes, and minimize the inherent risks of PN therapy.

Disclosure of Interest: None declared