Objectives: Catheter associated urinary tract infections (CAUTI) and central line associated blood stream infections (CLABSI) are preventable healthcare-associated infections associated with significant morbidity and mortality as well as increased health care costs. Optimizing methods to track and prevent these infections is an ongoing area of intense research. While great success in preventing infections has been obtained with simple evidence based approaches such as hand hygiene, use of full barrier precautions, and skin antisepsis, more research is needed. Our research investigated whether the presence of a critical care fellow had an effect on CLABSI and CAUTI rates as well as line day and standardized infection ratio (SIR).
Methods: We performed a retrospective study that counted number of line days, absolute infections and standardized infection ration (SIR) for both CLABSI and CAUTI in the SICU over a given time period of one year both prior to and after the presence of a critical care fellow.
Results: For CLABSI, line days in the one year period prior to the presence of a critical care fellow (CCF) was found to be 2687 compared to 1883 in one year period when fellow was present. Absolute infection rate was found to 3 both before and after presence of CCF. SIR was found to be .989 compared to 1.4 after presence of CCF. For CAUTI, line days prior to CCF presence was 4169 compared to 2997. Absolute infection rate was 9 compared to 5 after presence of CCF. SIR decreased from .609 to .188 with presence of CCF.
Conclusion: The presence of a critical care fellow in the SICU had a dramatic effect on line days for both urinary catheters and central lines. Furthermore, the both the absolute infection rate and standardized infection rate of CAUTI were drastically decreased after critical care fellow presence.
