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Infectious diseases
Research
Open versus closed IV infusion systems: a state based model to predict risk of catheter associated blood stream infections
  1. Nicholas Graves1,
  2. Adrian G Barnett1,
  3. Victor D Rosenthal2
  1. 1Institute of Health and Biomedical Innovation and School of Public Health, Queensland University of Technology, Brisbane, Australia
  2. 2Bernal Medical Center, Colegiales Medical Center, Department of Infectious Diseases and Hospital Epidemiology, Buenos Aires, Argentina
  1. Correspondence to Professor Nicholas Graves; n.graves{at}qut.edu.au

Abstract

Objectives To quantify the change in risk of central line associated blood stream infection (CLABSI) following the introduction of a closed infusion container in intensive care units (ICUs) in two Latin American cities.

Design A state-space model was used to describe the flow of admissions through the ICU. This approach correctly treats infection as a time-dependent covariate.

Results A closed system reduced the risk of CLABSI. The hazard ratios for the closed versus open container were between 0.15 and 0.31 (p values<0.001), indicating a clinically significant reduction in the risk of admissions having a CLABSI. A simulation study showed that a closed system reduced the number of infections, costs and deaths.

Conclusions The data reveal costs are saved and health benefits gained from fewer cases of CLABSI after adoption of a closed infusion system. Information is required on the costs of implementing the closed system widely in these settings.

This is an open-access article distributed under the terms of the Creative Commons Attribution Non-commercial License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited, the use is non commercial and is otherwise in compliance with the license. See: http://creativecommons.org/licenses/by-nc/2.0/ and http://creativecommons.org/licenses/by-nc/2.0/legalcode.

https://doi.org/10.1136/bmjopen-2011-000188

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    Footnotes

    • Correction notice The “To cite: …” information and running footer in this article have been updated with the correct volume number (volume 1).

    • To cite: Graves N, Barnett AG, Rosenthal VD. Open versus closed IV infusion systems: a state based model to predict risk of catheter associated blood stream infections. BMJ Open 2011;1:e000188. doi:10.1136/bmjopen-2011-000188

    • Funding This work was supported by Baxter Healthcare Corporation, Baxter, S.A. de C.V. in Mexico and Baxter Hospitalar Ltda. in Brazil. Baxter also provided Viaflex closed infusion containers.

    • Competing interests None.

    • Contributors VR organised data collection. NG, AB and VR performed all data analyses and contributed to drafting of the manuscript. NG, AB and VR wrote/checked the manuscript.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data sharing statement No additional data available.