Using Stethoscope Hygiene Barriers to Reduce Central Catheter-Associated Bloodstream Infection Rates

Central line [catheter]-associated bloodstream infections (CLABSIs) represent a significant mortality risk.

Due to a significant increase in CLABSI rate, a new CLABSI prevention bundle strategy was evaluated to determine whether it changed the CLABSI rate.

A before and after quality improvement project was performed in an 18-bed intensive care unit from March 1, 2021, to March 1, 2025. A CLABSI prevention bundle was implemented; CLABSI rates were compared for 1 year before to 3 years after intervention implementation. Additionally, clinician satisfaction surveys were collected.

The implemented bundle consisted of (1) replacement of disposable stethoscopes with touch-free, aseptic stethoscope diaphragm cover dispensers (DiskCover System, AseptiScope, Inc) in each intensive care unit room, and (2) requiring a chlorhexidine-impregnated dressing for all central catheters, with standardization and reeducation of bedside staff on central catheter dressing changes.

Of 5226 intensive care unit patients, the mean CLABSI rate was 4.42 (95% CI, 2.93-5.91) infections per 1000 patient central catheter days during the year before implementation, which decreased to 0.70 (95% CI, -1.21 to 2.61) in the 3 years after implementation. Clinicians reported the new strategy was easy to use and superior to disposable stethoscopes.

A CLABSI bundle that included touch-free, aseptic stethoscope hygiene barriers and chlorhexidine-impregnated dressings was highly effective at decreasing the CLABSI rate.