Email updates

Keep up to date with the latest news and content from BMC Proceedings and BioMed Central.

This article is part of the supplement: International Conference on Prevention & Infection Control (ICPIC 2011)

Open Access Open Badges Oral presentation

Sustained reduction of catheter-associated bloodstream infections by simulator-training and self-assessment

W Zingg1*, V Cartier2, C Inan2, S Touveneau1, F Clergue2, D Pittet1 and B Walder2

  • * Corresponding author: W Zingg

Author Affiliations

1 Infection control programme, University of Geneva Hospitals, Geneva, Switzerland

2 Division of Anaesthesiology, University of Geneva Hospitals, Geneva, Switzerland

For all author emails, please log on.

BMC Proceedings 2011, 5(Suppl 6):O13  doi:10.1186/1753-6561-5-S6-O13

The electronic version of this article is the complete one and can be found online at:

Published:29 June 2011

© 2011 Zingg et al; licensee BioMed Central Ltd.

This is an open access article distributed under the terms of the Creative Commons Attribution License (, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Introduction / objectives

Central line-associated bloodstream infection (CLABSI) is an avoidable complication in central venous catheter (CVC) use.


In this study at the University of Geneva Hospitals, individual CVCs were prospectively observed hospital-wide in all adult patients. A baseline period (9/2006-12/2006) was followed by an intervention (1/2008-12/2008) and a sustainability period (1/2009-12/2009). Primary outcome was CLABSI. Interventions aimed at catheter insertion by anaesthesiologists and included (1) a comprehensive checklist, (2) a ready-to-use CVC-insertion set, (3) a CVC-insertion cart containing all necessary material, (4) self-assessment of insertion practice using online documentation, (5) simulation-based CVC-insertion training for residents, (6) web-based information site and (7) feedback during postgraduate education. No intervention was done outside the anaesthesiology division.


Anaesthesiologists, intensivists and other physicians placed 1665 (42%), 1693 (43%), and 617 (15%) catheters, respectively. Cumulative catheter-days and median (IQR) dwell-time were 35,914 and 6 (3-11) days, respectively. Most CVCs were jugular (62%), followed by subclavian (23%) and femoral (15%). CLABSI-rates of anaesthesiologists, intensivists and others at baseline, intervention and sustainability were 4.9, 2.9, 2.0 (IRR 0.75; 95%CI 0.57-0.99; p=0.04); 2.7, 1.4, 2.2 (0.96; 95%CI 0.63-1.46; p=0.85); and 1.6, 2.1, 3.9 (1.54; 95%CI 0.83-2.84; p=0.17), respectively.


Improving CVC-insertion results in significant and sustained CLABSI-reduction. We consider self-assessment at catheter insertion and simulation-based training to have contributed most to the success.

Disclosure of interest

None declared.