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Updated: Jun 29, 2026
A Protocol to Set Up Needle-Free Connector with Positive Displacement on Central Venous Catheter in Intensive Care Unit
Published on: July 13, 2019
Effectiveness of a central line bundle campaign on line-associated infections in the intensive care unit
David Galpern1, Alejandro Guerrero, Ann Tu
1Department of Surgery, New York Methodist Hospital, Brooklyn, NY 11215, USA. DrGalpern@gmail.com
Background:
Central line-associated bloodstream infections occur commonly and are a potentially preventable source of morbidity in the critical care setting. The purpose of this study was to find a way to decrease central line-associated bloodstream infections.
Methods:
Data were collected from February 1, 2005, to April 31, 2007, on all patients in the critical care unit who had a central venous catheter placed at New York Methodist Hospital in Brooklyn, which is a community teaching hospital with 628 beds. After 5 months of baseline data collection, a multidisciplinary team created a central line bundle to be used when placing central venous catheters. A bundle is a protocol put in place to ensure that a procedure is performed using the latest evidence-based techniques. In this case, it included maximal barrier precautions, hand washing, skin preparation with ChloraPrep (Enturia, Leawood, Kan), use of a central line cart, and avoidance of femoral lines. All central lines placed from the time of intervention were placed using the bundle provided. The variables included the number of central lines, number of central line days, and development of a line infection.
Results:
The study period was 24 months, which included 9,938 central line days from a total of 1,395 central venous catheters. The average number of central line-associated bloodstream infections per 1000 catheter days decreased from 5.0 to 0.90 (P < .001) after the bundle intervention was initiated.
Conclusion:
The implementation of a central line bundle campaign resulted in a significant decrease in line-associated bloodstream infections. Based on our study, we recommend that this protocol be adopted nationwide.
Insights
Implementing a central line bundle significantly reduced central line-associated bloodstream infections in critical care. This evidence-based protocol offers a vital strategy for preventing these infections nationwide.
Area of Science:
- Infectious Disease
- Critical Care Medicine
- Healthcare Quality Improvement
Background:
- Central line-associated bloodstream infections (CLABSIs) are a common and preventable cause of morbidity in intensive care units.
- Effective strategies are needed to reduce the incidence of CLABSIs in critical care settings.
Purpose of the Study:
- To evaluate the effectiveness of a central line bundle in decreasing CLABSIs.
- To identify a scalable protocol for infection prevention in critical care.
Main Methods:
- A multidisciplinary team developed and implemented an evidence-based central line bundle protocol.
- The bundle included maximal barrier precautions, hand hygiene, skin antisepsis, use of a central line cart, and avoidance of femoral lines.
- Data on central line days and infections were collected before and after bundle implementation.
Main Results:
- The study encompassed 24 months, 9,938 central line days, and 1,395 central venous catheters.
- A significant reduction in CLABSIs was observed, decreasing from 5.0 to 0.90 infections per 1000 catheter days (P < .001).
Conclusions:
- The implementation of a central line bundle campaign led to a substantial decrease in CLABSIs.
- The study recommends nationwide adoption of this evidence-based protocol to improve patient safety.
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