674. Zeroing in on Zero:  An All-Out Effort to Reduce Central Line-Associated Blood-Stream Infections (CLABSIs) Pays Off
Session: Poster Abstract Session: Preventing Catheter Associated Infections
Friday, October 21, 2011
Room: Poster Hall B1
Background: Central line-associated blood-stream infections (CLABSIs) are associated with significant morbidity and mortality.  In recent years, many institutions have been able to reduce their CLABSI rates significantly through various interventions.  We report on the success achieved in significantly reducing CLABSI rates at a children’s hospital.

Methods: CLABSI prevention efforts at Children’s Hospital and Medical Center in Omaha, NE, began in 2005.  The new prevention program supported by the leadership and championed by the Process Improvement Department, focused on full barrier precautions and chlorhexidine gluconate skin antisepsis at line insertion.  A rigorous hand hygiene program was also initiated at the same time.  Additional measures included “real-time” reporting by e-mail to the units and clinicians as soon as a CLABSI was identified;  development and use of a tracking form for line insertions; development of a database to monitor all central venous catheters and performance of a Root Cause Analysis for each possible CLABSI;  a study of various injection caps that increased awareness of cap maintenance and infection prevention; a thorough review and revision of all institutional policies and procedures that applied to central lines to match national guidelines; the development of an Oncology Care Bundle; the use of Biopatch® for central line exit site dressings; standardization of the methodology for collecting blood cultures, and participation in a national collaborative effort to reduce CLABSIs.  

Results:   The initial CLABSI rate in January, 2005 was 5.8 per 1000 Device Days.  This decreased to 1 per 1000 device days in January, 2011.  Thus, CLABSI rates declined sequentially and significantly by 83% over the six-year period.

Conclusion: Children’s Hospital and Medical Center in Omaha, NE significantly reduced CLABSI rates over a six-year period.  This success was achieved through institution-wide support and sustained focus on this problem, careful data analysis, the inclusion of multidisciplinary stakeholders in decision making, and the adoption of incremental interventions.  Our institutional experience demonstrates that successful long-term reduction in CLABSIs can be achieved through sustained multidisciplinary commitment.

 


Subject Category: N. Hospital-acquired and surgical infections, infection control, and health outcomes including general public health and health services research

Archana Chatterjee, MD, PhD1, Andrew Macfadyen, MD2, Brenda Heybrock, RN, CIC3, Edward Truemper, MD, MS, FAAP2, Marcie Peterson, MSN, RN, CCRN2, Nancy Cornish, MD4, Alexia Bonte, BSN, RN, CCRN2, Lindsay Hegemann, BSN, RN, CPN3 and Sharon Plummer, RN, BS, CIC3, (1)Creighton University, Omaha, NE, (2)Children's Hospital and Medical Center, Omaha, NE, (3)Infection Prevention, Children's Hospital and Medical Center, Omaha, NE, (4)Children's Hospital, Omaha, NE

Disclosures:

A. Chatterjee, None

A. Macfadyen, None

B. Heybrock, None

E. Truemper, None

M. Peterson, None

N. Cornish, None

A. Bonte, None

L. Hegemann, None

S. Plummer, None

Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 20 with the exception of research findings presented at IDSA press conferences.