Weekly transparent dressing changes linked to increased bacteremia rates.

Background: In 2000, the rate of primary bloodstream infections (BSIs) was double that in 1999 for intensive care unit (ICU) patients with triple lumen catheters, pulmonary artery catheters, or both. In December 1999, changes in products and practices related to site care were implemented as a cost-saving initiative.

Objective: To determine the factors contributing to an increase of BSIs after cost-saving measures for site care had been introduced.

Design: Epidemiologic study involving prospective identification of infection.

Setting: A community teaching hospital.

Participants: Patients in a 20-bed, medical-surgical ICU identified as having triple lumen catheters, pulmonary artery catheters, or both and a primary BSI during 2000 and 2001.

Methods: Alcohol swab sticks were reintroduced and the frequency of transparent dressing changes and site care was increased. Inservice presentations were conducted on aseptic technique and posters were placed reviewing site care protocol for physicians and nurses.

Results: The incidence of primary BSIs decreased significantly (P = .003) during a 3-month intervention and this decrease was sustained through the following 12 months.

Conclusions: Prolonging the interval between the change of transparent dressings from 3 times weekly to once weekly and switching from alcohol swab sticks to pads was associated with an increase in BSIs, which was controlled after returning to the original policy.