Nurses leading the way: Transforming CLABSI prevention

Central line-associated bloodstream infections (CLABSIs) are a persistent threat to patient safety, contributing to significant morbidity, mortality, and health care costs. An acute cluster of three CLABSIs on a 25-bed Cardiovascular and Thoracic Surgery unit prompted an urgent response to address this critical safety issue.

This nurse-led quality improvement (QI) initiative aimed to eliminate CLABSIs and establish a sustainable culture of zero harm on the unit by empowering frontline staff to lead evidence-based practice changes.

Guided by the Donabedian and Magnet® models, nurses conducted a root cause analysis and implemented a multifaceted intervention. Key strategies included innovative education, peer-to-peer validation of central line care, daily compliance monitoring, and enhanced patient engagement. CLABSI rates and bundle compliance data were tracked using run charts to monitor performance and guide continuous improvement.

The initiative resulted in the complete elimination of CLABSIs on the unit. This achievement of a zero-infection rate was successfully sustained for more than 5 consecutive years.

Empowering frontline nurses to lead QI is a highly effective strategy for improving patient safety outcomes. This project demonstrates that a "culture of zero" is attainable through interprofessional collaboration, data-driven practices, and sustained leadership support. The initiative provides a replicable framework for other organizations seeking to eliminate health care-associated infections.