Sustaining Improvements in CLABSI Reduction in a Pediatric Cardiac Intensive Care Unit
Presented By:
Sarah Brandt BSN, RN, CCRN; Jennifer Gauntt MD; Kevin Dolan MSHA; Jaime Manley MSN, RN, CPN; Roxann Tyner MSN, RN, CCRN-K; Wendi Beauseau BSN, RN, CIC; Janet Simsic MD
Overview:
Introduction: Central line associated blood stream infections (CLABSIs) are preventable events that may lead to increased morbidity and mortality. The objective of this quality project was to reduce the incidence of CLABSIs in a pediatric cardiothoracic intensive care unit (CTICU).
Methods: Institutional review of an unacceptably high rate of CLABSIs led to implementation of four new interventions. These interventions included: use of sequential cleaning between line accesses; Kamishibai card (K-Card) audits; central line utilization and entry (CLUE) audits; and proctored simulation of line access.
Results: There was a reduction in CLABSI rate from 1.52 per 1000 central line days in 2018 to 0.37 per 1000 central line days in 2020 and 0.32 in 2021. Additionally, central line days per 100 patient days decreased from 77 days to 70 days over the study period. The CTICU went 389 days without a CLABSI from October 2020 to November 2021.
Conclusion: Implementation of multiple interventions led to successful reduction in the incidence of CLABSIs in our unit, with sustained reduction over one year.
