Facing a 48.5 percent increase in central line-associated bloodstream infections (CLABSIs) from 2010 to 2011, a 420-bed hospital in Florence, S.C., took action. The front-line staff from the facility’s surgical intensive care unit (SICU) implemented quality improvement measures and joined The Carolinas Center for Medical Excellence’s (CCME’s) CLABSI Target Zero Learning and Action Network (LAN), which helps participating hospitals eliminate CLABSIs in their patient populations.
Participating in CCME’s LAN has allowed the SICU unit to share and learn tools, resources, and best practices and utilize CCME’s technical assistance offered through face-to-face meetings, conference calls, and webinars. Since 2011, the SICU unit has successfully implemented the following processes to help reduce CLABSIs:
- Reviewing the necessity of using central lines in patients with their clinicians and case managers.
- Bathing all ICU patients and dialysis patients with diluted chlorhexidine gluconate (CHG), an antiseptic.
- Using SwabCaps with IV lines. The caps have a sponge inside that is saturated with alcohol and bathes the port of the IV line while it is being screwed on and off, protecting from the line from contamination.
- Replacing a CHG patch under the central line dressing with an all-in-one CHG gel dressing that allows the line to be secured non-invasively.
- Drawing blood from a central line only if ordered by a physician.
- Implementing an infection prevention bundle for dialysis patients. This includes swabbing the patient’s skin, nose, and mouth with CHG, using a triple antibiotic ointment for central line care, and changing in-needle connectors to prevent blood reflux in the catheter.
- Providing routine maintenance and dressing care for all central lines with a dedicated “vascular access” team. Based on guidelines, dressing changes are done once a week or more often if needed.
As a result of these efforts, the CLABSI rate in the SICU unit remained at zero from January 2012 through October 2013.