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Related Experiment Videos

Evidence-based practice to reduce central line infections.

Marta L Render1, Suzanne Brungs, Uma Kotagal

  • 1VA Inpatient Evaluation Center, Veterans Affairs Medical Center, Cincinnati, USA. marta.render@med.va.gov

Joint Commission Journal on Quality and Patient Safety
|June 10, 2006
PubMed
Summary

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A collaborative project significantly reduced central line-associated bloodstream infections (CLABSIs) by 50% in intensive care units (ICUs). Hospital leadership and evidence-based practices were key to improving patient safety and infection control.

Area of Science:

  • Healthcare quality improvement
  • Infection prevention and control
  • Patient safety

Background:

  • Nine Cincinnati healthcare systems partnered in a 2003 project to reduce hospital-acquired infections.
  • The two-year initiative focused on intensive care unit (ICU) patients and surgical site infections (SIP).

Purpose of the Study:

  • To implement and evaluate evidence-based practices for reducing catheter-related bloodstream infections (CR-BSIs) and surgical site infections (SIPs).
  • To assess the impact of a collaborative approach and hospital leadership on infection rates.

Main Methods:

  • Hospitals were randomized to CR-BSI or SIP reduction projects, with both implemented in year two.
  • Infection control professionals led the implementation of evidence-based practices, including maximal sterile barriers and chlorhexidine for CR-BSI reduction.

Related Experiment Videos

  • Team leaders utilized a secure, deidentified web-based database to track process information.

    • Main Results:

    • Four initial sites reduced central line infections by 50% (from 1.7 to 0.4 per 1000 line days; p < .05).
    • Adherence to evidence-based practices increased from 30% to nearly 95% by the project midpoint.
    • The study demonstrated a significant reduction in CR-BSIs through collaborative efforts.

    Conclusions:

    • Strong hospital leadership and a local community of practice fostered physician cooperation and successful problem-solving.
    • Implementation of forcing functions, such as checklists and modified procedure kits, enhanced the reliability of infection control practices.
    • The study established that an appropriate benchmark for central line infections in ICUs is less than 1 infection per 1000 line days.