Our aim was to ascertain the effect of an infection control program, using education and performance feedback on intensive care units, for intravascular device (IVD)-associated bloodstream infection (BSI).

Within 4 level III, adult, intensive care units in Argentina, all admitted, adult patients with a central vascular catheter in place for at least 24 hours were included. This was a prospective before-and-after trial in which rates of IVD-associated BSI determined during a period of active surveillance without education or performance feedback (phase 1) were compared after sequential implementation of an infection control program using education (phase 2) and performance feedback (phase 3).

A total of 1219 IVD days were accumulated in phase 1; 586 during phase 2; and 4140 during phase 3. Compliance with central vascular catheter—site care improved significantly from baseline during the study period. Overall rates of IVD-associated BSI were lowered significantly from baseline after sequential implementation of education and performance feedback (11.10 vs 46.63 BSI/1000 IVD days; relative risk=0.25; 95% confidence interval=0.17-0.36; P<.0001). Rates of IVD-associated BSI decreased significantly after implementation of an educational program (phase 1 to phase 2) (relative risk 0.37; confidence interval 0.19-0.73; P=.0026) and further reductions were seen after implementation of a performance feedback program (phase 2 to phase 3), although the reduction did not reach statistical significance (9.9 vs 17.06 BSI/1000 IVD days; relative risk 0.58; confidence interval 0.29-1.18; P=.11). Additional analysis of the data using χ² for trends demonstrated that sequential implementation of an education and performance feedback program resulted in a significant trend toward reduced rates of IVD-associated BSI (P<.001).

Implementation of an infection control program, using education and performance feedback, resulted in significant reductions in rates of IVD-associated BSI.