Successful multimodal intervention to prevent vascular catheter-related bacteremia in conventional wards (PREVCATH)

Catheter-related bacteremia (CRBs) is a major cause of healthcare-associated morbidity and mortality. Although preventive measures have reduced CRB incidence in intensive care units (ICUs), their impact in conventional hospital wards remains limited. This study evaluated a multimodal intervention programme to prevent CRB in non-ICU settings. We conducted a prospective, quasi-experimental before-and-after multicentre interventional study across eight Spanish hospitals. Three periods were defined: (i) Pre-intervention (12 months), during which standard practices were maintained; (ii) Intervention (6 months), comprising staff training and implementation of insertion and maintenance bundles; and (iii) Post-intervention (12 months), during which outcomes were monitored. Crude CRB incidence rates across the study periods were compared using Poisson regression models, with patient-days included as the offset. A total of 7,737 vascular catheters were placed (mean dwell time, 3.0 days) in 4,557 patients admitted to medical (72%) and surgical (28%) wards during the intervention phase. Devices used were mainly short peripheral catheters (90.1%), followed by midlines (6.6%), peripherally inserted central catheters (3.2%), and central lines (0.2%), primarily for medication administration (98%). CRB incidence dropped from 0.22 per 1,000 patient-days pre-intervention to 0.16 during intervention and 0.13 post-intervention. Comparison of crude incidence rates showed a lower CRB incidence during the intervention and post-intervention periods than during the pre-intervention period (incidence rate ratio 0.59; 95% confidence interval 0.35–0.98). Implementation of a multimodal prevention program was associated with a lower incidence of CRB in conventional hospital wards, and this lower incidence was maintained during the 12-month post-intervention follow-up.