A Quality Improvement Initiative to Decrease Central Line-Associated Bloodstream Infections During the COVID-19...

Area of Science:

• Healthcare Quality Improvement
• Infection Prevention and Control
• Patient Safety

Background:

• Central line-associated bloodstream infections (CLABSIs) pose significant risks and costs to patients and healthcare systems.
• The COVID-19 pandemic presented challenges to maintaining quality improvement initiatives for CLABSI prevention.
• A baseline CLABSI rate of 4.62 per 1000 line days was recorded in the Ontario health system.

Purpose of the Study:

• To reduce CLABSIs by 25% by the year 2023.
• To implement and evaluate quality improvement interventions in a community health system.

Main Methods:

• A root cause analysis was performed by an interprofessional committee to identify areas for improvement.
• Interventions focused on governance, education, standardization of processes, equipment, data reporting, and safety culture, implemented over four Plan-Do-Study-Act cycles.
• Key outcome measure was the CLABSI rate per 1000 central lines; process measures included checklist usage and capped lumens, with CLABSI readmissions as a balancing measure.

Main Results:

• CLABSIs decreased by 51%, from a baseline rate of 4.62 to 2.34 per 1000 line days.
• Central line insertion checklist usage increased from 22.8% to 56.9%.
• Central line capped lumens usage increased from 72% to 94.3%, with a reduction in CLABSI readmissions.

Conclusions:

• Multidisciplinary quality improvement interventions effectively reduced CLABSIs by 51% across a health system.
• These interventions demonstrated success in enhancing patient safety during the COVID-19 pandemic.
• Sustained efforts in quality improvement are crucial for preventing healthcare-associated infections.