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Volume 47, Number 4, August 2014

National action plan to eliminate central line-associated bloodstream infections in Taiwan 

Shu-Hui Tseng, Li-Jung Chien, Feng-Yee Chang

Received: March 25, 2014    Revised: April 1, 2014    Accepted: April 3, 2014   


Corresponding author:

Feng-Yee Chang, Division of Infectious Diseases, Department of Internal Medicine, Tri-Service General Hospital and National Defense Medical Center, Taipei City, Taiwan
Corresponding Author InformationCorresponding author. No. 161, Sec. 6, Minquan E. Rd., Neihu Dist., Taipei City 114, Taiwan. 


Background and purpose: 

The World Health Organization has proposed three major challenges1 in patient safety: healthcare-associated infection (HAI); safe surgery saves lives; and antimicrobial resistance. The first priority for patient safety is to confront HAI, which obviously indicates that HAI has become an important issue in global public health.

HAI remains a current challenge in Taiwan. HAI is an important indicator that reflects healthcare quality and patient safety. Moreover, HAI significantly increases morbidity, mortality, and medical costs.2 According to the published statistical data from the National Health Insurance (NHI) of Taiwan in 2011, the estimated extra medical costs of HAI cases are USD 0.92 billion (NTD 27.7 billion).3

A central line is an invasive medical device and invasive procedures are high-risk factors leading to infection. Based on global surveillance of patients with bloodstream infections, urinary tract infections, or pneumonia, approximately 50% of patients are implanted with an invasive medical device.4

According to the 2012 surveillance data, the rate of central line associated bloodstream infections (CLABSI) among intensive care units of medical centers and regional hospitals in Taiwan is 5.5 and 3.5/1000 central line days, respectively.5 Hence, a government-lead force combined with professional organizations promoting central line care quality and creating patient safety is imperative; the Centers for Disease Control, Taiwan (Taiwan CDC) has started planning a national action plan to eliminate CLABSI in Taiwan— the central line care quality improvement project—since 2012.6 The phases of the central line care quality improvement project include a planning phase, an executive phase, and a policy evaluation phase.