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

Background: Catheter-related bacteraemia (CRBs) are 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. Methods: We conducted a prospective, 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. The incidence rate ratio (IRR) for CRB was analysed using Poisson regression models, with the total number of hospital stays as the offset. Results: During the intervention, 7,737 vascular catheters were placed (mean dwell time: 3.0 days) in 4,557 patients across medical (72%) and surgical (28%) wards. 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 hospital stays pre-intervention to 0.16 during intervention and 0.13 post-intervention. Poisson regression showed a significant CRB reduction after the intervention (IRR 0.59; 95% CI: 0.35–0.98). Conclusions: The implementation of a multimodal preventive programme in conventional hospitalisation wards was associated with a significant and sustained reduction in CRB incidence over a 12-month follow-up period. These findings highlight the importance and feasibility of extending preventive strategies beyond the ICU setting.