Eradicating central line-associated bloodstream infections statewide: the Hawaii experience

Area of Science:

• Healthcare Quality Improvement
• Infectious Disease Prevention
• Critical Care Medicine

Background:

• Central line-associated bloodstream infections (CLABSIs) pose a significant risk in intensive care units (ICUs).
• A national collaborative aimed to reduce CLABSI rates through standardized safety protocols.

Purpose of the Study:

• To evaluate the effectiveness of a national ICU collaborative for CLABSI reduction in Hawaii.
• To determine if a national infection prevention program could be successfully implemented in a unique geographic setting.

Main Methods:

• Analysis of CLABSI rates in 20 ICUs across 16 hospitals in Hawaii from July 2009 to December 2010.
• Implementation of a comprehensive unit-based safety program and multifaceted CLABSI prevention strategies.
• Monitoring of infection rates and catheter days throughout the intervention period.

Main Results:

• The mean CLABSI rate decreased from 1.5 to 0.6 infections per 1000 catheter days post-intervention.
• The median CLABSI rate remained at zero throughout the study period.
• Hawaii's ICUs achieved significant reductions, indicating successful program spread.

Conclusions:

• A national ICU collaborative can be successfully implemented in Hawaii to reduce CLABSIs.
• The findings provide further evidence that most CLABSIs are preventable with targeted interventions.
• This study supports the scalability of national infection prevention programs in diverse healthcare environments.