Fostering an interdisciplinary culture of collaborative discussion to prevent central line-associated bloodstream infections.

BACKGROUND

Few studies describe quantitative thresholds for daily device review that attempt to drive a decrease in device utilization (DU) for central venous catheter devices. Increased DU in the period spanning March 2020 through December 2021 paralleled an increased incidence of central line-associated bloodstream infections (CLABSI) within a Medical Surgical Intensive Care Unit (ICU) of an acute care hospital. An intervention tool was developed to foster targeted discussions around DU to ultimately reduce the risk of CLABSI.

METHODS

An evidence-based performance improvement initiative was implemented in March 2022 which included the deployment of an ICU Rounding Checklist tool to drive ICU intensivist signature sign-off of standardized device indications in collaboration with ICU nurses.

RESULTS

Significantly fewer central venous catheters were present in ICU patients following implementation of the intervention, χ2(1) = 7.06, P < .01. Concurrently, zero CLABSI events were encountered during the 32-month intervention evaluation period.

CONCLUSIONS

In addition to evidence-based bundle compliance elements and leadership visibility of device de-escalation opportunities, hospitals should optimize methods to encourage collaborative discussions between nurses and physicians to impact central venous catheter utilization, reducing the risk of CLABSIs.