An evidence-based project to decrease catheter-related bloodstream infections

Shedlarski, Antoinette; White‐Williams, Connie

doi:10.1097/01.ccn.0000427243.28841.0e

Cited by 3 publications

(1 citation statement)

References 20 publications

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“…Subsequent to performing a root-cause analysis, we concluded that there was a significant lack of understanding the importance of central line maintenance measures. As there is some evidence indicating that bundled educational and behavioural interventions are effective in reducing CLABSI incidence, [14][15][16][17][18][19][20] our assumption was that the implementation of a central line maintenance bundle approach would result in CLABSI reductions.…”

Section: Introductionmentioning

confidence: 99%

Bundle approach used to achieve zero central line-associated bloodstream infections in an adult coronary intensive care unit

et al. 2021

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BackgroundCentral venous catheterisation is commonly used in critical patients in intensive care units (ICU). It may cause complications and attribute to increase mortality and morbidity. At coronary ICU (CICU) of cardiac hospital, central line-associated bloodstream infection (CLABSI) rate was 2.82/1000 central line days in 2015 and 3.11/1000 central line days in 2016. Working in collaboration with Institute for Healthcare Improvement (IHI), we implemented evidence-based practices in the form of bundles in with the aim of eliminating CLABSI in CICU.MethodsIn collaboration with IHI, we worked on this initiative as multidisciplinary team and tested several changes. CLABSI prevention bundles were tested and implemented, single kit for line insertion, simulation-based training for line insertions, standardised and real-time bundle monitoring by direct observations are key interventions tested. We used model for improvement and changes were tested using small Plan-Do-Study-Act cycles. Surveillance methods and CLABSI definition used according to National Healthcare Safety Network.ResultsThe CLABSI rate per 1000 patient-days dropped from 3.1 per 1000 device-days to 0.4 per 1000 device-days. We achieved 757 days free of CLABSI in the unit till December 2018 when a single case happened. After that we achieved 602 free days till July 2020 and still counting.ConclusionsImplementation of evidence-based CLABSI prevention bundle and process monitoring by direct observation led to significant and subsequently sustained improvement in reducing CLABSI rate in adult CICU.

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Section: Introductionmentioning

confidence: 99%

Bundle approach used to achieve zero central line-associated bloodstream infections in an adult coronary intensive care unit

et al. 2021

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Adherence to the central line bundle in intensive care: An integrative review

Burke

Jakub

Kellar

2021

American Journal of Infection Control

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A Central Line Care Maintenance Bundle for the Prevention of Central Line–Associated Bloodstream Infection in Non–Intensive Care Unit Settings

O’Neil

Ball

Wood

et al. 2016

Infect. Control Hosp. Epidemiol.

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Objective To evaluate a central line care maintenance bundle to reduce central line-associated bloodstream infection (CLABSI) in non-ICU settings. Design Before-after trial with 12 month follow-up period. Setting 1250-bed teaching hospital. Participants Patients with central lines on eight general medicine wards. Four wards received the intervention and four served as controls. Intervention A multifaceted catheter care maintenance bundle consisting of educational programs for nurses, update of hospital policies, visual aids, a competency assessment, process monitoring, regular progress reports, and consolidation of supplies necessary for catheter maintenance. Results Data were collected for 25,542 catheter-days including 43 CLABSI (rate = 1.68 per 1,000 CL-days) and 4,012 catheter dressing observations. Following the intervention, a 2.5% monthly decrease in the CLABSI incidence density was observed on intervention floors, but this was not statistically significant (95% confidence interval (CI); −5.3 – 0.4). On control floors, there was a smaller, but marginally significant decrease in CLABSI incidence during the study (change in monthly rate = −1.1%; 95% CI, −2.1 - −0.1). Implementation of the bundle was associated with improvement in catheter dressing compliance on intervention wards (78.8% compliance pre-intervention vs. 87.9% during intervention/follow-up; p<0.001) but improvement was also observed on control wards (84.9% compliance pre-intervention vs. 90.9% during intervention/follow-up; P = .001). Conclusions A multi-faceted program to improve catheter care was associated with improvement in catheter dressing care, but no change in CLABSI rates. Additional study is needed to determine strategies to prevent CLABSI in non-ICU patients.

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An evidence-based project to decrease catheter-related bloodstream infections

Cited by 3 publications

References 20 publications

Bundle approach used to achieve zero central line-associated bloodstream infections in an adult coronary intensive care unit

Bundle approach used to achieve zero central line-associated bloodstream infections in an adult coronary intensive care unit

Adherence to the central line bundle in intensive care: An integrative review

A Central Line Care Maintenance Bundle for the Prevention of Central Line–Associated Bloodstream Infection in Non–Intensive Care Unit Settings

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