Gilbert, C.R., Lee, H.J., Akulian, J.A., Hayes, M., Ortiz, R., Hashemi, D., . . . Yarmus, L.B. (2015). A quality improvement intervention to reduce indwelling tunneled pleural catheter infection rates. Annals of the American Thoracic Society, 12, 847–853.
To evaluate the effects of an organizational intervention to reduce pleural catheter infections
Medical records of patients receiving indwelling pleural catheters (IPC) for malignant effusions were reviewed to describe the overall findings and practices from 2009 to 2014. The protocol was then updated to include changes so that all placements occurred within a single location, all patients received perioperative antibiotics within 60 minutes prior to IPC insertion, and full body sterile draping was conducted. A review of all cases was done after six months of follow-up.
Overall, the IPC infection rate was 8.2% prior to the intervention and decreased to 2.2% after the intervention (p = 0.049).
The quality improvement interventions implemented were associated with a significant reduction in overall IPC infection rates.
This study showed that a quality improvement intervention involving a review of practices and related outcomes and an implementation of protocol changes aimed at reducing IPC infection rates was successful because of the overall reduction of infection rates. Principles related to surgical site infection and catheter infection prevention were incorporated into the organizational protocol changes that were made.