Other Titles
Unit Based Team Control CLABSI rates down in ICU [Poster Title]
Abstract
Background: During the COVID surges, the CLABSI rates are monitored internally. We have seen an increase in both the CLABSI rate and the Standardized Infection Ratio (SIR) in our unit. The SIR average of CLABSI was 4.5 with the regional target of 0.50. Although central lines (CL) play a significant role in Intensive Care Unit (ICU) for the administration of lifesaving treatments, CLABSI is associated with significant morbidity, mortality, and cost. Moreover, failure to remove a CL in patients without indications for its necessity was highly associated with 30-day all-cause mortality.
Purpose: To evaluate the effectiveness of utilization of a Central Line Champion Team (CLCT) in reducing CLABSI SIR rate and Incidence among ICU patients.
Evidence Synthesis/Recommendation: Extensive literature review was performed in search for interventions to reduce CLABSI among hospitalized patients admitted in ICU. Guidelines and recommendations highly supported in identifying a nurse-led CL champions as an effective way to reduce CLABSI rate.
Implementation: Our evidence-based practice (EBP) project started with CLCT member identification. Then team members were trained by a clinical expert, using face-to-face instruction with return demonstration and competency check list with focus on care and management to prevent infection. The CLCT conducted weekly rounds focusing on adherence to the policy. To ensure that we perform standardized quality checks on all central lines in ICU, we created a “Daily Central Line Assessment Tool” used by the charge nurses. The purpose of this tool is to certify that all nurses are following the policy. The tool also helped guide nurses to initiate communication with rounding physician to remove unnecessary lines. Real time feedback was embraced by the ICU staff via a secure group chat and included central line audit result in daily huddles.
Evaluation of Outcomes: CLABSI SIR and incidence were obtained from the STATIT scorecard pre and post implementation to evaluate effectiveness of the team. After the project was implemented in March 2022, ICU only had 2 CLABSI cases (April 2022- Feb 2024) and a significant decrease in SIR to 0. Also, SUR decreased from 0.75 to 0.54 by promoting removal of unnecessary central lines. Team decided to continue PDSA because the unit had 2 CLABSI cases in Mar 2024 due to critical conditions and severe prognosis of chronic wound by implementing PIV vasopressor policy to minimize using CL and delay care.
Notes
References:
Beville, A., Heipel, D., Vanhoozer, G., & Bailey, P. (2021). Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days. Current infectious disease reports, 23(12), 23. https://doi.org/10.1007/s11908-021-00767-w Central Line-Associated Bloodstream Infections (CLABSI) | Agency for Healthcare Research and Quality (ahrq.gov)
Owings, A., Graves, J., Johnson, S., Gilliam, C., Gipson, M., & Hakim, H. (2018). Leadership line care rounds: Application of the engage, educate, execute, and evaluate improvement model for the prevention of central line–associated bloodstream infections in children with cancer. American Journal of Infection Control, 46(2), 229–231. https://doi.org/10.1016/j.ajic.2017.08.032
Reed SM, Brock AJ, Anderson TJ. CE: Champions for central line care. Am J Nurs. 2014 Sep;114(9):40-8; test 49. doi: 10.1097/01.NAJ.0000453751.16141.a9. PMID: 25121950.
Russell TA, Fritschel E, Do J, Donovan M, Keckeisen M, Agopian VG, Farmer DG, Wang T, Rubin Z, Busuttil RW, Kaldas FM. Minimizing central line-associated bloodstream infections in a high-acuity liver transplant intensive care unit. Am J Infect Control. 2019 Mar;47(3):305-312. doi: 10.1016/j.ajic.2018.08.006. Epub 2018 Oct 15. PMID: 30333081.
Walker, Rita L., "Reducing CLABSI Rate Among ICU Patients" (2018). Walden Dissertations and Doctoral Studies. 6144.https://scholarworks.waldenu.edu/dissertations/6144
Sigma Membership
Non-member
Type
Poster
Format Type
Text-based Document
Study Design/Type
Other
Research Approach
Translational Research/Evidence-based Practice
Keywords:
Acute Care, Implementation Science, Central Line-Associated Bloodstream Infections, CLABSI, Intensive Care Units, ICU
Recommended Citation
Surasrisakul, Issareegorn; Villanueva, John; Younes, Amelia; Amador, Jaymie; and Martinez, Tatiana, "Unit Based Team Control Central Line-Associated Bloodstream Infection (CLABSI) Rates Down in ICU" (2025). Biennial Convention (CONV). 34.
https://www.sigmarepository.org/convention/2025/posters_2025/34
Conference Name
48th Biennial Convention
Conference Host
Sigma Theta Tau International
Conference Location
Indianapolis, Indiana, USA
Conference Year
2025
Rights Holder
All rights reserved by the author(s) and/or publisher(s) listed in this item record unless relinquished in whole or part by a rights notation or a Creative Commons License present in this item record. All permission requests should be directed accordingly and not to the Sigma Repository. All submitting authors or publishers have affirmed that when using material in their work where they do not own copyright, they have obtained permission of the copyright holder prior to submission and the rights holder has been acknowledged as necessary.
Review Type
Abstract Review Only: Reviewed by Event Host
Acquisition
Proxy-submission
Date of Issue
2025-11-21
Unit Based Team Control Central Line-Associated Bloodstream Infection (CLABSI) Rates Down in ICU
Indianapolis, Indiana, USA
Background: During the COVID surges, the CLABSI rates are monitored internally. We have seen an increase in both the CLABSI rate and the Standardized Infection Ratio (SIR) in our unit. The SIR average of CLABSI was 4.5 with the regional target of 0.50. Although central lines (CL) play a significant role in Intensive Care Unit (ICU) for the administration of lifesaving treatments, CLABSI is associated with significant morbidity, mortality, and cost. Moreover, failure to remove a CL in patients without indications for its necessity was highly associated with 30-day all-cause mortality.
Purpose: To evaluate the effectiveness of utilization of a Central Line Champion Team (CLCT) in reducing CLABSI SIR rate and Incidence among ICU patients.
Evidence Synthesis/Recommendation: Extensive literature review was performed in search for interventions to reduce CLABSI among hospitalized patients admitted in ICU. Guidelines and recommendations highly supported in identifying a nurse-led CL champions as an effective way to reduce CLABSI rate.
Implementation: Our evidence-based practice (EBP) project started with CLCT member identification. Then team members were trained by a clinical expert, using face-to-face instruction with return demonstration and competency check list with focus on care and management to prevent infection. The CLCT conducted weekly rounds focusing on adherence to the policy. To ensure that we perform standardized quality checks on all central lines in ICU, we created a “Daily Central Line Assessment Tool” used by the charge nurses. The purpose of this tool is to certify that all nurses are following the policy. The tool also helped guide nurses to initiate communication with rounding physician to remove unnecessary lines. Real time feedback was embraced by the ICU staff via a secure group chat and included central line audit result in daily huddles.
Evaluation of Outcomes: CLABSI SIR and incidence were obtained from the STATIT scorecard pre and post implementation to evaluate effectiveness of the team. After the project was implemented in March 2022, ICU only had 2 CLABSI cases (April 2022- Feb 2024) and a significant decrease in SIR to 0. Also, SUR decreased from 0.75 to 0.54 by promoting removal of unnecessary central lines. Team decided to continue PDSA because the unit had 2 CLABSI cases in Mar 2024 due to critical conditions and severe prognosis of chronic wound by implementing PIV vasopressor policy to minimize using CL and delay care.
Description
Our project highlighted the importance of adapting intervention based on evidence to prevent CLABSI and also empowered nurses to proactively be involved in quality improvement and collaboration between nursing and providers. CLCT helped with maintenance competency, adhered to policy, and produce sustained change on the unit. Using “Daily Central Line Assessment Tool” is a necessity to reduce of using unnecessary CLs and peripheral lines.