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Central venous catheters are vital in the care of critically ill patients and help in monitoring hemodynamic parameters, allowing safe administration of intravenous medications that cannot be given peripherally. Approximately 250 000 bloodstream infections occur yearly, and most are related to central lines.1 Central line-associated bloodstream infections (CLABSIs) lead to increased mortality, health care expenses, and prolonged hospital stays.1 Our organization was not satisfied with the current state of CLABSIs that were occurring at our hospital. An interprofessional team was formed with a clinical nurse leader serving as the facilitator to put processes in place to decrease the total number of CLABSIs that were occurring. Using rapid-cycle process methodologies, several Plan-Do-Study-Act cycles were harnessed, including the following interventions: creation of blood culture ordering algorithms, development of a monitoring report to provide oversight of all central lines, optimize technology to initiate tasks for evidence-based maintenance, and a monitoring report to ensure that physicians and nurses were adhering to the guidelines. In collaboration with information technology, the creation of rules to automate decisions and monitoring reports to provide ongoing oversight have been key to this effort. There is a downward trend in the total number of CLABSIs to date, and the number is expected to decline further.




1. Bell T, O'Grady NP. Prevention of central line-associated bloodstream infections. Infect Dis Clin North Am. 2017;31(3):551-559. doi:10.1016/j.idc.2017.05.007 [Context Link]