Central Line-Associated Blood Stream Infection Prevention in a Long Term Acute Care Hospital

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Introduction/Purpose: Preventing a central line-associated bloodstream infection (CLABSI) is a challenging, complex patient safety issue. Between 12% and 25% of patients that develop a CLASBI will die. CLABSI prevalence at the site of this project was above target. The target for FY21 was a standardized infection ratio (SIR) of 0.91, and prior to intervention, SIR was 1.81 year to date with an upward trend. The purpose of this project was to develop standard work to decrease CLABSIs and improve prevention strategies. Methods: An interprofessional team improved CLABSI prevention processes through targeted rounding and collaboration in this 50-bed Long-Term Acute Care Hospital (LTACH) by applying evidence-based practice and establishing shared responsibility for central line removal in the long-term acute care patient population to eliminate CLABSIs. Results: The implementation of targeted, interprofessional rounding to evaluate central line necessity decreased central line days by 18%, decreased the number of CLABSIs by 29%, decreased the CLABSI Rate per 1,000 Patient Days by 23%, decreased the SIR by 16%, and increased the number of days since last infection by 55%. Data indicated a beneficial effect of intervention on metrics tracked without reaching statistical significance. Discussion: Interprofessional team collaboration improved the process of evaluating central line necessity through applying evidence-based practices to reduce CLABSIs. Establishing standard processes increased central line removal and improved patient outcomes.

CLABSI, central line-associated bloodstream infection, healthcare associated infection, long-term acute care, prevention strategies, central venous line