An urban community university hospital decreased the rate of central line-associated bloodstream infections in its medical-surgical intensive care unit by 92 percent over four years through a combination of bottom-up and top-down approaches to implementing a central line bundle, according to a letter to the editor in the American Journal of Infection Control.
Researchers studied a 19-bed ICU's progress in reducing CLABSIs starting with a baseline period of January 2005 to September 2007 and moving through early, mid- and late postintervention periods, during which CLABSI interventions were gradually implemented.
In the early postintervention period, October 2007 to September 2008, random line insertion audits were conducted for central line bundle elements. In the mid-postintervention period, October 2008 to September 2009, the ICU implemented vascular access selection criteria in addition to multiple other interventions and empowered nurses to stop central line insertion if protocol was not followed. Finally, in the late postintervention period, October 2009 to December 2011, active and visible involvement of hospital administration was implemented.
In the baseline period, the CLABSI rate was 3.35 infections per 1,000 catheter days. The CLABSI rate decreased 53 percent to 1.59 per 1,000 catheter days in the early postintervention period, further decreased to 1.39 in the middle stage and dropped to 0.28 by the end of the study — a 92 percent decrease from baseline.
The authors attributed the ICU's successful CLABSI rate reduction to the combination of healthcare providers' engagement in the intervention and administration's visible involvement, according to the letter.
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Researchers studied a 19-bed ICU's progress in reducing CLABSIs starting with a baseline period of January 2005 to September 2007 and moving through early, mid- and late postintervention periods, during which CLABSI interventions were gradually implemented.
In the early postintervention period, October 2007 to September 2008, random line insertion audits were conducted for central line bundle elements. In the mid-postintervention period, October 2008 to September 2009, the ICU implemented vascular access selection criteria in addition to multiple other interventions and empowered nurses to stop central line insertion if protocol was not followed. Finally, in the late postintervention period, October 2009 to December 2011, active and visible involvement of hospital administration was implemented.
In the baseline period, the CLABSI rate was 3.35 infections per 1,000 catheter days. The CLABSI rate decreased 53 percent to 1.59 per 1,000 catheter days in the early postintervention period, further decreased to 1.39 in the middle stage and dropped to 0.28 by the end of the study — a 92 percent decrease from baseline.
The authors attributed the ICU's successful CLABSI rate reduction to the combination of healthcare providers' engagement in the intervention and administration's visible involvement, according to the letter.
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