Challenge 2F HAI

Central Line Associated Blood Stream Infections (CLABSI)

Executive Summary Checklist

In order to implement a program to eliminate central line-associated blood stream infections (CLABSIs) the following implementation plan will require these actionable steps. The following checklist was developed by Dr. Peter Pronovost, in 2001. This 5 item checklist reduces infections when inserting a central venous catheter (CVC).1

  • Commitment from hospital leadership to support a program to reduce and then eliminate CLABSIs.
  • Implement evidence-based guidelines to prevent the occurrence of CLABSIs, including: insertion, maintenance, and standardized access procedures:
    • Such as: Arrow International® PSI with Integral Hemostasis Valve/Side Port or Pressure Injectible Quad-Lumen Central Venous Catheterization Kit with Blue FlexTip®, ARROWg+ard Blue PLUS® Catheter and Sharps Safety Features.
  • Doctors should:
    • Perform a “time-out”.
    • Wash their hands with soap.
    • Clean the patient’s skin with chlorhexidine antiseptic.
    • Put sterile drapes over the entire patient.
    • Wear a sterile mask, hat, gown and gloves.
    • Put a sterile dressing over the catheter site.
  • Develop an education plan for attendings, residents and nurses to cover key curriculum pertaining to the prevention, insertion and maintenance of central lines.
  • Encourage continuous process improvement through the implementation of quality process measures and metrics.
  • Standardize a central-line kit based on the needs of your facility, and implement technology that will have a significant return on investment (ROI) such as:
    • Arrow International® PSI Kit with Integral Hemostasis Valve/Side Port or Arrow International® Pressure Injectable Quad-Lumen Central Venous Catheterization Kit with Blue FlexTip®, ARROWg+ard Blue PLUS® Catheter and Sharps Safety Features.
  • Efforts should be focused on eliminating all blood draws from central access catheters. This includes patient with longer-standing catheters (e.g. dialyses catheters).
  • All CLABSIs should have a root cause analysis (RCA) completed by the unit where the infection occurred with multidisciplinary participation including nursing, physicians and infection prevention specialists. All learnings from the RCA should be implemented.

Between the 2017 World Patient Safety, Science & Technology Summit and the 2017 Midyear Planning Meeting a workgroup comprised of experts representing administrators, clinicians, technologists and patient advocates will meet to update this APSS. If you are interested in joining this workgroup, please email us.

References

Parent Challenge

  1. Challenge 2: Healthcare-associated Infections (HAIs)