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ICU outcomes following a Central Line Associated Blood Stream Infections (CLABSI) reduction quality improvement
Ronald Harris1, Nitin L Mehdiratta2, Morgan A Rosser1
1Department of Anesthesiology, Duke University School of Medicine, Durham, NC, USA.
Background:
Central Line Associated Blood Stream Infections (CLABSI) are significant complications for hospitalized patients. Several different approaches have been used to reduce CLABSI.
Objective:
This study aimed to (1) describe a systematic approach used to analyze and reduce CLABSI rates in a surgical ICU (SICU) at a quaternary care medical facility (CLABSI reduction bundle) and (2) examine the association of the bundle on CLABSI rates in the SICU, compared to six unexposed health system ICUs.
Methods:
Retrospective analysis of 14,022 adult patients with > 0 central line days within a single health system in the southeastern United States. The CLABSI intervention bundle was created and implemented in July 2021. Single and multiple interrupted time series analyses were performed to assess the impact of the CLABSI bundle on CLABSI rate in SICU (compared to control ICUs) pre- and post-intervention. Secondary analyses examined the association of the bundle with ICU mortality and length of stay.
Results:
The CLABSI bundle was associated with a significant immediate effect in reducing the CLABSI rate in the SICU compared with control ICUs. There was no significant change in the slope of CLABSI rate post-intervention, compared to control ICUs. There was no significant association of the CLABSI reduction bundle on ICU length of stay or mortality in the SICU.
Conclusion:
The CLABSI bundle was associated with an immediate reduction in CLABSI incidence in the SICU compared to unexposed ICUs. A simple, bundled intervention can be effective in reducing CLABSI incidence in a surgical ICU population.
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