A Quality Improvement Project to Decrease CLABSIs in Non-ICU Settings

Area of Science:

• Healthcare-associated infection (HAI) prevention
• Quality improvement in nursing
• Evidence-based practice implementation

Background:

• Central line-associated bloodstream infections (CLABSIs) in non-intensive care units (non-ICUs) exceeded internal targets.
• A quality improvement (QI) initiative was launched by Doctor of Nursing Practice (DNP)-prepared nurse leaders to address this issue.
• The intervention focused on implementing 2% chlorhexidine gluconate (CHG) cloths for daily bathing of non-ICU patients with central lines.

Approach:

• A pre-post-design QI study was conducted across 34 non-ICU settings.
• Multifaceted educational strategies and electronic health record reminders supported CHG bathing implementation.
• Statistical process control (SPC) charts monitored CLABSI rates, and documentation compliance was audited.

Key Points:

• A 22.8% clinically significant reduction in CLABSI rates was observed post-intervention.
• CLABSI rates remained stable across the health system after implementation.
• CHG bathing documentation compliance improved from 77% to 94% system-wide.

Conclusions:

• The study supports the use of CHG cloths for daily bathing in non-ICU settings to reduce CLABSIs.
• Sustaining this practice change requires ongoing reinforcement through annual booster sessions.
• Nurse leaders reported satisfaction with the CHG bathing implementation process.