Hubungan Kejadian Central Line Associated Bloodstream Infection (CLABSI) dan Implementasi Central Line Bundle di Ruang Perawatan Intensif Anak RSUP Haji Adam Malik

Abstract

Background : Central venous access has important role in the care of critically ill children. One of the devastating complication of inserting central venous catheter (CVC) is central line associated bloodstream infection (CLABSI). The CVC colonization is prerequsite to develop CLABSI. Central Line Bundle (CLB) is the effective strateg to prevent CLASBI. In Indonesia, there no reporting study about implementation of CLB and its effectiveness prevent CLABSI. Method : This is cross sectional study in Pediatric Intensive Care Unit (PICU) in Adam Malik Hospital Medan from Oktober 2018 to March 2019. From all children with CVC, the blood culture’s samples was taken simultaneosly from peripher and CVC about minimum 3 cc according to age and body weight. Based on CDC guidlines, CLABSI is developing the same microorgansim in blood from vein and CVC. The implementasion of Central Line Bundle was observed by nurse supervisor per day. Result : Total sample was 68 children, 3 children was excluded. From the blood culture result, there is no CLABSI (0.0%), 20 of 68 develops CVC colonization, dan 40 of 68 no developing CLABSI or colonization. The rate of implementation of insertion CLB was 92.2%. It is higher than the rate implementation of maintenace CLB that was 79.7%. Statistically, there is a significant relationship between implementation of insertion CLB with the incidence of CVC colonization. In the multivariate analysis, we found that blood transfusion is the most significant factor to develop CVC colonization (p< 0.048, OR= 11.4, CI= 0.049-0.975). Conclusion : There is a relationship between incidence CLABSI and the implementasion of insertion CLB in PICU Adam Malik Hospital.