Reducing Central Line

Related Bloodstream

Infections in Hospitalized Adults

Team

Infection Control Department

ICU Leadership

OPPORTUNITY STATEMENT

Central line infections are a common medical problem in hospitalized patientsThese translate into increased rates of mortality, morbidity and costsSolutions based on national guidelines and successful practice at other healthcare organizations

Goal: To reduce central line infections by 40%

Solutions Implemented Standardized central line insertion protocol

disseminated to staff Antimicrobial coated central line catheters kits

containing Chloraprep, full body sterile drape and safety devices available

Standardized supply lists for line insertion Education and testing of faculty and nursing staff on

central line insertion protocols through e-learning modules

ADULT ICU CLR-BSI RATES

0.0

0.2

0.4

0.6

0.8

1.0

1.2

1.4

UCL = 1.18

Mean = 0.53

UCL = 0.78

Mean = 0.29GOAL

Before After

Results

Reduction of Central Line Related Bloodstream Infections from 5.3 to 2.9/1000 Central Line

Days

Infection rates have

decreased by 47%47%

Results (continued)

Average cost per bloodstream infection: $56,000*

7 fewer infections in 2006 than 2005

7 x $56,000 = $$392,000 in cost 392,000 in cost savingssavings

* O’Grady NP. Alexander M, Dellinger EP, et al: Guidelines for the prevention of intravascular catheter-related infections. MM/WR Recomm Rep; 2002 51(RR-10): 1-29

Next Steps

Decrease catheter related bloodstream infections to 2/1000 central line days per LUHS Patient Safety Plan FY ’07.

Continue to present data at adult ICU Quality Improvement meetings for discussion.

Review the process of insertion and maintenance of central lines on patients who had bloodstream infections and make improvements in practice as needed.

Capture cost savings on prevented infections and report periodically to senior leadership.