Prevent Device/Procedure Infections
Central line-associated bloodstream infections, or CLABSIs, are associated with significant morbidity, mortality, and increased length and cost of hospital stay. However, the majority of CLABSIs are preventable. Staphylococcus aureus is one of the leading causes of CLABSIs. This section discusses evidence-based best practices for CLABSI Prevention in ICUs and non-ICUs.
Presentations
After reviewing the content of this presentation, viewers will be able to:
- Define a central line-associated bloodstream infection (CLABSI) and identify its significance to patient safety and MRSA prevention.
- Outline key evidence-based strategies and targets for CLABSI prevention.
- Describe implementation approaches to ensure that evidence-based best practices are in place for every patient with a central line.
Documents:
- ​Prevention of CLABSI – Slides (PPTX, 6 MB)
- Prevention of CLABSI – Facilitator Guide (DOCX, 3.2 MB)
One-Pagers
One Pager: CLABSI Prevention to Reduce Harm from MRSA: Four Key Steps - One-Pager (DOCX, 799 KB)
Outlines the four fundamental steps to prevent CLABSI.
One Pager: Preventing CLABSI: Components of a Central Line Insertion Bundle - One-Pager (DOCX, 2.1 MB)
Outlines best practices of central line insertion to prevent CLABSI.
One Pager: Preventing CLABSI: Components of Central Line Maintenance Bundle - One-Pager (DOCX, 1.6 MB)
Outlines the best practices of central line maintenance for CLABSI prevention.
Tools & Resources
Implementing a standardized central line insertion checklist helps staff ensure that proper procedure is performed every time a central line is inserted and helps identify any breaches in technique.
Below are publicly available central line insertion checklists that you may consider adapting for your program.
Providing staff with a central line maintenance checklist helps them to remember daily best practices.
Other available central line maintenance checklists are listed below.
Tool: Central Line Rounds Form (DOCX, 398 KB)
Central line rounds are conducted daily by a multidisciplinary team to systematically evaluate the necessity of each central line and enable the prompt removal of unnecessary lines. This form is designed to guide that process.
CUSP Tool: Daily Goals Checklist for ICU (DOCX, 413 KB)
CUSP Tool: Daily Goals Checklist for Non-ICU (DOCX, 393 KB)
The Daily Goals Checklist is a tool to guides healthcare teams when reviewing patient needs and setting goals for each patient. It is particularly useful when integrated into Central Line Rounds.
More detail on the Daily Goals process can be found on the ´óÏóÊÓƵwebsite:
AHRQ: Daily Goals During Interdisciplinary Rounds: Facilitator Guide
´óÏóÊÓƵTeamSTEPPS Module 1: Communication
Staff often report difficulty speaking up when they observe issues during central line insertion or maintenance. AHRQ’s TeamSTEPPS Program offers communication strategies and training exercises to help staff feel more comfortable speaking up in actual medical situations.
Video:
This video demonstrates proper technique for scrubbing a central line hub. The video is produced by Johns Hopkins Medicine and hosted on YouTube.
The ´óÏóÊÓƵToolkit for Preventing CLABSI and CAUTI in ICUs offers clinical and cultural guidance aimed at reducing CLABSI and CAUTI rates in intensive care units. Although designed originally with ICUs in mind, the recommendations and resources are generally applicable in various healthcare settings. Some elements are highlighted below:
´óÏóÊÓƵToolkit for Reducing Central Line-Associated Blood Stream Infections (2012)
The ´óÏóÊÓƵToolkit for Reducing Central Line-Associated Blood Stream Infections (CLABSI) was designed to implement evidence-based practices to reduce CLABSI. More than 1,000 intensive care units across the country have used the tools in this toolkit, along with the ´óÏóÊÓƵCore CUSP Toolkit.
