Use of Implementation Science for a Sustained Reduction of Central-Line-Associated Bloodstream Infections in a...

Area of Science:

• Healthcare Management
• Infection Prevention and Control
• Implementation Science

Background:

• Central-line-associated bloodstream infections (CLABSIs) pose a significant risk in intensive care settings.
• Burn intensive care units (BICUs) manage high-risk patients susceptible to healthcare-associated infections.
• Effective strategies are needed to reduce CLABSI rates in specialized units.

Purpose of the Study:

• To describe the application of implementation science at organizational and unit levels to reduce CLABSIs.
• To evaluate the impact of a multi-faceted intervention in a regional burn intensive care unit.
• To assess the sustainability of CLABSI reduction over a three-year period.

Main Methods:

• A single-center, observational, quasi-experimental study was conducted in a regional BICU.
• Implementation science guided interventions including leadership commitment, infrastructure support, and staff engagement.
• Unit-level interventions included the Comprehensive Unit-based Safety Program (CUSP)/Translating Research Into Practice (TRIP) model, new protocols, and catheter care improvements.

Main Results:

• The integrated implementation science framework led to a significant reduction in CLABSI rates.
• CLABSI rates decreased from 15.5 per 1,000 central-line days to zero.
• Zero CLABSIs were sustained for three consecutive years, indicating a sustained improvement.

Conclusions:

• CLABSIs in high-risk units, such as BICUs, are preventable.
• A structured, multi-level implementation science paradigm is effective for sustained infection reduction.
• Organizational and unit-level collaboration is crucial for successful infection control initiatives.