Hospitals in pursuit of excellence

Successful Reduction of Central Line-Associated Blood Stream Infections Outside the ICU: A Multi-Hospital Collaborative

Outside the intensive care unit, catheters remain in place for a longer duration; therefore, it is important to ensure the use of appropriate line maintenance practices by nursing staff. Starting in 2008, six hospitals in the Rochester area joined together to initiate surveillance and to reduce central line-associated blood stream infections on 37 units outside the ICU. Activities included: Simplifying the collection of the central line denominator data; validating a sampling method (collection of data once a week) to estimate monthly line days was adopted; quarterly feedback of comparative CLABSI rates was provided to nursing leaders and unit managers to increase overall knowledge and encourage continued surveillance and compliance; a line care maintenance protocol was created using evidence-based literature; nurses'  knowledge and practice were surveyed pre- and post-education; practices for dressing change and accessing central lines were audited regularly.