CLABSI Conversations: Lessons From Peer-to-Peer Assessments to Reduce Central Line-Associated Bloodstream Infections

Area of Science:

• Healthcare-associated infections
• Infection prevention and control
• Patient safety

Background:

• A national collaborative aimed to reduce central line-associated bloodstream infections (CLABSIs) in hospitals.
• Some participating hospitals faced challenges in significantly reducing CLABSI rates despite collaborative efforts.

Purpose of the Study:

• To describe the development of a peer-to-peer assessment process called CLABSI Conversations.
• To identify practical, actionable practices that enabled intensive care unit (ICU) teams to achieve and sustain low CLABSI rates.

Main Methods:

• Developed and implemented a learning-oriented, peer-to-peer assessment process (CLABSI Conversations).
• Peer teams visited hospitals to identify infection prevention barriers and share best practices from successful ICUs.
• Synthesized common successful practices into actionable recommendations.

Main Results:

• CLABSI Conversations facilitated the identification of key barriers and effective strategies for infection prevention.
• Successful ICU teams achieved a CLABSI rate of less than 1 infection per 1000 catheter-days for at least one year.
• Ten common practices were identified, emphasizing leadership commitment, accountability, staff empowerment, and standardized protocols.

Conclusions:

• A structured, peer-led assessment process can effectively identify and disseminate best practices for CLABSI reduction.
• Sustained reduction in CLABSIs requires a multi-faceted approach involving leadership, clinical staff, and robust infection control programs.
• Empowering frontline staff and standardizing care are crucial for achieving and maintaining low infection rates.