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Am J Surg. 2014 Jun;207(6):817-23. doi: 10.1016/j.amjsurg.2013.08.041. Epub 2014 Jan 2.

Reducing the rate of catheter-associated bloodstream infections in a surgical intensive care unit using the Institute for Healthcare Improvement Central Line Bundle.

Author information

1
Department of Surgery, University of California, Los Angeles, CA, USA.
2
Department of Surgery, Oregon Health & Science University, Portland, OR, USA.
3
Department of Surgery, University of Arizona, Tucson, AZ, USA.
4
Department of Surgery, Brigham and Women's Hospital, Boston, MA, USA.
5
Department of Surgery, Oregon Health & Science University, Portland, OR, USA; Section of Surgical Critical Care, Portland VA Medical Center, Portland, OR, USA. Electronic address: darren.malinoski@va.gov.

Abstract

BACKGROUND:

Central line-associated bloodstream infections (CLABSIs) are a significant source of morbidity and mortality. This study sought to determine whether implementation of the Institute for Healthcare Improvement (IHI) Central Line Bundle would reduce the incidence of CLABSIs.

METHODS:

The IHI Central Line Bundle was implemented in a surgical intensive care unit. Patient demographics and the rate of CLABSIs per 1,000 catheter days were compared between the pre- and postintervention groups. Contemporaneous infection rates in an adjacent ICU were measured.

RESULTS:

Baseline demographics were similar between the pre- and postintervention groups. The rate of CLABSIs per catheter days decreased from 19/3,784 to 3/1,870 after implementation of the IHI Bundle (1.60 vs 5.02 CLABSIs per 1,000 catheter days; rate ratio .32 [.08 to .99, P < .05]). There was no significant change in CLABSIs in the control ICU.

CONCLUSIONS:

Implementation of the IHI Central Line Bundle reduced the incidence of CLABSIs in our SICU by 68%, preventing 12 CLABSIs, 2.5 deaths, and saving $198,600 annually.

KEYWORDS:

Catheter-associated line infections; Central venous catheters; Checklist; Healthcare cost; Infection control; Quality improvement

PMID:
24576582
DOI:
10.1016/j.amjsurg.2013.08.041
[Indexed for MEDLINE]

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