Implementing a Better Bundle to Achieve and Sustain a Zero Central Line-Associated Bloodstream Infection Rate

Abstract

The objective of every health care facility is achieving and maintaining a zero central line-associated bloodstream infection (CLABSI) rate. Interventions to enhance care were put into place, and changes in CLABSI rates were tracked. Data were collected from January 2003 through June 2009. The interventions included the following: a dedicated vascular access team; swabbable clear positive displacement needleless connector; chlorhexidine-impregnated disk; flushing with 20 mL of normal saline; rigorous central line care education; increased use of peripherally inserted central catheters; and daily review of necessity. A significant drop to zero CLABSIs occurred after the introduction of several new central line care practices.

National Survey of Practices to Prevent Healthcare-Associated Infections in Thailand: The Role of Safely Culture and Collaboratives

“…20 Other previous studies have demonstrated that having a dedicated and trained vascular access team is associated with decreases in CLABSI. 21 Promoting and establishing dedicated PICC line insertion teams may be an effective strategy for reducing CLABSI, as the team members could serve as champions for the prevention practices within the recommended bundle of care and assist in the development and implementation of educational infection prevention efforts.…”

Use of a Central Catheter Maintenance Bundle in Long-Term Acute Care Hospitals

“…17 In addition to a CLABSI prevention bundle based on evidence-based practices to reduce the incidence of infections, a multidisciplinary team was developed for infection prevention and control, and a checklist was used to track bundle compliance. [18][19][20] The purpose of this study was to determine whether implementation of a central catheter maintenance bundle, together with a central catheter team and a compliance checklist, reduces the rate of hospital-acquired CLABSIs, thereby improving the quality of care in LTACHs.…”

Findings of the International Nosocomial Infection Control Consortium (INICC), Part III Effectiveness of a Multidimensional Infection Control Approach to Reduce Central Line—Associated Bloodstream Infections in the Neonatal Intensive Care Units of 4 Developing Countries

“…Regarding education of healthcare personnel involved in the insertion, care, and maintenance of CLs about CLABSI prevention, 27 infection control practitioners received education on the following practices: (a) performance of direct observation of hand hygiene compliance; (b) placement and condition of sterile gauze or sterile polyurethane dressing on the insertion site; 31,40 (c) gauze dressing replacement every 48 hours and replacement of transparent semipermeable membrane dressings at least every 7 days, with the recording of the date and time of the dressing replacement; and (d) use of structured observation tools at regularly scheduled intervals. 31,41…”