Reducing Central Line-Associated Bloodstream Infections With a Multipronged Nurse-Driven Approach.

Area of Science:

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

Background:

• Central line-associated bloodstream infections (CLABSIs) persist as a significant hospital-acquired infection, despite existing central catheter bundles.
• The introduction of pulmonary artery catheters in a cardiac progressive care unit led to increased central catheter days and a rise in CLABSI rates.

Purpose of the Study:

• To decrease the incidence of CLABSIs in a cardiac progressive care unit.
• To evaluate the effectiveness of a standardized central catheter rounding process.

Main Methods:

• A quality improvement project was implemented, involving nursing staff conducting central catheter rounds three times weekly.
• Rounds included critical assessment of central catheter dressings, determination of catheter necessity, and patient education on dressing care.
• Data collected via mobile devices were analyzed to track interventions and outcomes.

Main Results:

• Over 2692 rounds for 707 patients, central catheter rounds reduced the CLABSI rate from 1.86 to 0.0.
• Key interventions included meticulous dressing management, monitoring insertion sites, addressing product allergies, and ensuring process sustainability.
• The reduction in CLABSIs was achieved despite a continuous increase in central catheter days.

Conclusions:

• Systematic assessment, intervention, and education regarding central catheter dressings are crucial for reducing CLABSIs.
• Central catheter rounds serve as a valuable addition to existing CLABSI prevention bundles.
• A dedicated algorithm for central catheter dressing management empowers nurses in decision-making regarding dressing changes and product selection.