2002 Fiscal Year Final Research Report Summary
A modified Management system to reduce CR-BSI in Patient with TPN Therapy
| Project/Area Number |
13672471
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| Research Category |
Grant-in-Aid for Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Section | 一般 |
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| Research Field |
基礎・地域看護学
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| Research Institution | University of Shizuoka |
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Principal Investigator |
DOI Matsuko University of Shizuoka, School of Nursing, Professor, 看護学部, 教授 (00155615)
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| Co-Investigator(Kenkyū-buntansha) |
HORII Tosinobu University of Shizuoka, School of Medicine, School of Medicine, Assistant Professor, 医学部, 助手 (80283430)
SAITO Asako University of Shizuoka, School of Nursing, Assistant Professor, 看護学部, 助手 (20326127)
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| Project Period (FY) |
2001 – 2002
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| Keywords | Total Parenteral Nutrition / CR-BSI / CVC / CV Line / Infusion / Infusion Bag / Contamination / Hand washing |
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| Research Abstract |
This study was designed to reduce the incidence of intravascular device-related infections (CR-BSI) by elucidating the infection route. And we constructed the prevention strategy of the infection by reducing the contamination of intravenous (IV) line and infusion with microorganisms. We found that the skin at the insertion site was frequently colonized (20%). Among the positive cases, S. epidermidis strain was isolated (60%) as the potential microorganism of skin colonization. No microorganism was detected in closed-type IV lines, but was detected in open-type IV lines (16.6%). These results suggested that frequent manipulation of the catheter via hub could be one of the major contributing factors of line contamination. No contamination was found in TPN infusions that were fixed by pharmacists in aseptic condition. On the other hand, those that were fixed at wards by nurses, 5.9% of infusions were contaminated with bacteria. Inadequate maintenance of hygiene for instance, hand washing, gloves use by medical personnel at the time of line change and site care often cause iatrogenic transmiddion of microorganisms to other parts of the patient's body, as well as to other patients. Our findings suggest that an aseptic condition for the preparation of TPN solutions and an appropriate TPN management are essential to reduce the contamination of catheter hub and infusion with microorganism. Based on these results, we modified the conventional method of TPN management, and evaluated its efficacy by performing the second observational study. We found that rate of hand washing, gloves use, and decontamination techniques were increased more than than before by medical personnel during this second observational study period.
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