A Collaborative Approach to Reducing Central Line-Associated Bloodstream Infections

Layne, Diana; Anderson, Teresa

doi:10.1097/ncq.0000000000000419

Cited by 4 publications

(9 citation statements)

References 3 publications

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“…The initiatives in the articles reviewed were supported by a variety of staff members including direct care nurses, nursing leaders, and physicians. 4,[9][10][11]14,15,17,18 Utilization of a consistent team 15,17,18 and education to ensure standardization of the review of the central lines by the auditing teams contributed to successful CLABSI prevention interventions. 4,9,10,11,14 To our knowledge, a collaborative initiative involving the clinical nurse specialist (CNS) and clinical nurse leader (CNL) roles to prevent CLABSIs has not been explored.…”

Section: Available Knowledgementioning

confidence: 99%

“…Researchers have shown that CLABSI bundle compliance is sustained by auditing and rounding processes. Auditing may occur in a variety of formats including peer-to-peer, collaborative processes with infection preventionists and other members of the interdisciplinary team, and incorporation with leader rounding 9–18. A quality improvement (QI) project implementing a collaborative, systematic approach to proper line maintenance was found to be effective in reducing CLABSI rates, with rates reduced from 3.9 per 1000 days in 2011 to 0.3 per 1000 patient-days in 2014 in a neonatal intensive care unit 18.…”

Section: Available Knowledgementioning

confidence: 99%

Section: Available Knowledgementioning

confidence: 99%

“…Layne and Anderson15 demonstrated that collaboration between clinical leaders, quality and infection control leaders, and direct care staff is essential to initiate and sustain outcomes with a successful CLABSI prevention initiative. The initiatives in the articles reviewed were supported by a variety of staff members including direct care nurses, nursing leaders, and physicians 4,9–11,14,15,17,18. Utilization of a consistent team15,17,18 and education to ensure standardization of the review of the central lines by the auditing teams contributed to successful CLABSI prevention interventions 4,9,10,11,14.…”

Section: Available Knowledgementioning

confidence: 99%

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CLABSI Rounding Team

Pate

Brelewski

Rutledge

et al. 2022

Journal of Nursing Care Quality

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Background: Central line-associated bloodstream infections (CLABSIs) are an ongoing concern in health care, resulting in increased mortality, morbidity, length of stay, and additional costs to hospitals. Local Problem: Despite intermittent improvements in CLABSI rates within our facility, long-term sustainment has been challenging. Methods: This was a quality improvement project including a collaborative rounding approach supported by specialty nursing roles. Interventions: In addition to implementing a variety of evidence-based interventions, the rounding team performed audits to assess performance and created focused education tools to address the identified opportunities within each individual unit. Results: High levels of engagement as evidenced by increased audit completion resulted in CLABSI reductions. However, 2 peaks in CLABSI rates were associated with higher volumes of coronavirus disease (COVID-19) hospitalizations and decreased audits. Conclusions: Despite challenges correlated with COVID-19, a collaborative rounding team promotes and enhances awareness of prevention methods and a culture of safety.

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Section: Available Knowledgementioning

confidence: 99%

Section: Available Knowledgementioning

confidence: 99%

Section: Available Knowledgementioning

confidence: 99%

Section: Available Knowledgementioning

confidence: 99%

See 2 more Smart Citations

CLABSI Rounding Team

Pate

Brelewski

Rutledge

et al. 2022

Journal of Nursing Care Quality

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“…To evaluate whether solutions were contaminated before use, Brock-Utne et al10 randomly tested stock IV solution bags (Hospira Inc, Lake Forest, IL) and noted that no microbial growth was evident. Other authors have explored tangentially related issues, such as strategies to decrease CLABSIs after a spike in incidence,11 as well as negative and positive aspects of central catheters, and best evidence to avoid CLABSIs 12. Others reported on the establishment of a vascular access team and provided guidance to decrease central line usage and incidence of CLABSIs 13.…”

Section: Introductionmentioning

confidence: 99%

The Relationship Between Central Line-Associated Bloodstream Infections and Extended Intravenous Solution Hang Times

Mianecki

Peterson

2021

Journal of Infusion Nursing

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Central line-associated bloodstream infections (CLABSIs) can result in increased morbidity and mortality and billions of dollars of costs per year to institutions and patients. Fluctuating availability of manufacturers' supplies of intravenous (IV) solutions have created issues for health systems in which policy and procedures have been examined regarding extended hang time for IV solutions. This article examined the relationship between extended hang times of nonadditive IV solutions and incidence of CLABSIs in intensive and general practice inpatient units in a quaternary care setting. The incidence of CLABSIs with extended hang times of up to 96 hours, of nonadditive IV solutions, has demonstrated that significant changes in CLABSIs were not evident.

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Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

Draper,

Nelson,

Taylor

et al. 2024

Journal of Infusion Nursing

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Due to low compliance by bedside nursing with a central line-associated bloodstream infection (CLABSI) prevention bundle and increased CLABSI rates, a mandatory re-education initiative at a 1200-bed university-affiliated hospital was undertaken. Despite this, 2 units, housing high-risk immunocompromised patients, continued to experience increased CLABSI rates. A quality improvement before-after project design in these units replaced bedside nursing staff with 2 nurses from the vascular access team (VAT) to perform central vascular access device (CVAD) dressing changes routinely every 7 days or earlier if needed. The VAT consistently followed the bundled components, including use of chlorhexidine gluconate (CHG)-impregnated dressings on all patients unless an allergy was identified. In this case, a non-CHG transparent semipermeable membrane dressing was used. There were 884 patients with 14 211 CVAD days in the preimplementation period and 1136 patients with 14 225 CVAD days during the postimplementation period. The VAT saw 602 (53.0%) of the 1136 patients, performing at least 1 dressing change in 98% of the patients (n = 589). The combined CLABSI rate for the 2 units decreased from 2.53 per 1000 CVAD days preintervention to 1.62 per 1000 CVAD days postintervention. The estimated incidence rate ratio (IRR) for the intervention was 0.639, a 36.1% reduction in monthly CLABSI rates during the postimplementation period.

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A Collaborative Approach to Reducing Central Line-Associated Bloodstream Infections

Cited by 4 publications

References 3 publications

CLABSI Rounding Team

CLABSI Rounding Team

The Relationship Between Central Line-Associated Bloodstream Infections and Extended Intravenous Solution Hang Times

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

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