Central Line Bundle Care Approach: An Improvement Project in A Tertiary Care Hospital

Abstract

Background: Central line-associated bloodstream infections (CLABSIs) can be avoided by implementing well-coordinated, evidence-based multimodal preventive strategies. Central line care bundle is a package to minimize CLABSI. Objectives: This study aims reduce CLABSI rate and to maintain that reduced rate in ICU units in a tertiary care hospital; and to improve the perception of core knowledge related to CLABSI prevention. Methodology: A prospective intervention improvement project was performed to reduce CLABSIs rate in an intensive care unit. The study was conducted in three consecutive phases. CLABSI rates were calculated throughout the three phases. Comprehensive initiatives for insertion and maintenance of CLABSI preventive bundles were coordinated through active educational and training programs. Results: CLABSI endemic rate per 1000 CL days dropped from 34.19‰ in phase I to 27.6‰ and 6.76 ‰ in phase II and III respectively. During implementation of our improvement project the overall compliance to CLABSI preventive bundles gradually increased from 35% at the beginning of phase II to 80%and 100% at the end of phase II and III respectively. Conclusions: Bundle approach for preventing CLABSI proved to be a very effective strategy.