의료진 대상 리마인더 프로그램이 중환자실 중심정맥관 관련 혈류감염에 미치는 효과

Effects of Reminder Program for Healthcare Providers on Central Line-Associated Blood Stream Infection in an Intensive Care Unit

Purpose: This study aimed to develop a reminder program and evaluate the impacts of the program on adherence to maximal sterile barrier precautions (MBP), duration of catheterization, and central line-associated blood stream infection rates (CLA-BSIs). Methods: A simulated control group pretest-posttest design was used. The participants were 35 physicians, 17 nurses and 165 patients (control group=75, intervention group=90) with central catheter insertions for more than 48 hours admitted to a tertiary hospital. Data were collected from an university-affiliated hospital in Gwangju, South Korea. The intervention group received the reminder program which consisted of MBP adherence education, short message service (adherence feedback to MBP, optimal recommendation, and hand washing), and self-report checklist on central venous catheter management. Results: The adherence level of MBP was significantly increased from 87.7% to 97.9% (p =.026) after implementation of the reminder program. The duration of catheterization significantly decreased in the intervention group compared to the control group (from 10.6 to 7.4 days, p =.024). The incidence of CLA-BSI rate decreased in the intervention group compared to the control group but it was not statistically significant. Conclusion: This study showed some effectiveness of the reminder program to improve adherence of MBP and duration of catheterization among patients with central line. Further studies are needed to evaluate effects of the program on CLA-BSI rate using a randomized clinical trial with larger samples and diverse settings.