The role of nutritional support team to reduce infection rate

Aim: Our goal was to analize whether an intervention involving implementation of nutritional support team and staff education would decrease central line-associated bloodstream infection rate in a pediatric population on parenteral nutrition.
Material and methods: A retrospective study of 27 patients receiving parenteral nutrition was conducted before, during and after the reorganisation of nutritional support team. Children between 2 to 48 months of age were included in the study, with tunneled catheter (Broviac). The reorganisation program was based on building the nutritional support team, education and training, implementation of parenteral nutrition and catheter placement procedures, minimizing the manipulations connected with the catheter, authorisation of staff involved with the catheter, education and motivation of the nutritional support team. We analized the frequency of catheter related blood stream infection (CRBSI). The CRBSI was recognised when there was worsening of general condition, temperature > 38.5°C increased inflammatory parameters and a recognised pathogen cultured from blood (not related to an infection at another site).
Results: During the analized period 4777 parenteral nutriton procedures were performed. The estimated mean preintervention central line-associated bloodstream infection was 11.5 infections per 1000 catheter days, which decreased to 6.2 infections per 1000 catheter days during and 1.1 infections per 1000 catheter days after reorganisation of nutritional support team.
Conclusion: The intervetion involving implementation of nutritional support team, staff education, increased awareness and practice changes decreased catheter related blood stream infection rates connected with parenteral nutrition in hospital.