CLABSI Conversations: Lessons From Peer-to-Peer Assessments to Reduce Central Line-Associated Bloodstream Infections. Issue 2 (April 2016)

• Record Type: Journal Article
• Authors: Pham, Julius Cuong; Goeschel, Christine A.; Berenholtz, Sean M.; Demski, Renee; Lubomski, Lisa H.; Rosen, Michael A.; Sawyer, Melinda D.; Thompson, David A.; Trexler, Polly; Weaver, Sallie J.; Weeks, Kristina R.; Pronovost, Peter J.
• Is Part Of: Quality management in health care. Volume 25:Issue 2(2016)
• Publication Date: 2016-04
• Subjects: central line–associated bloodstream infection -- CLABSI -- intensive care unit -- peer-to-peer assessment; Medical care -- Quality control -- Periodicals; Total quality management -- Periodicals; Health services administration -- Periodicals; 362.1068
• DOI: 10.1097/QMH.0000000000000091
• Languages: English
• ISSNs: 1063-8628

Abstract

Abstract : A national collaborative helped many hospitals dramatically reduce central line–associated bloodstream infections (CLABSIs), but some hospitals struggled to reduce infection rates. This article describes the development of a peer-to-peer assessment process (CLABSI Conversations) and the practical, actionable practices we discovered that helped intensive care unit teams achieve a CLABSI rate of less than 1 infection per 1000 catheter-days for at least 1 year. CLABSI Conversations was designed as a learning-oriented process, in which a team of peers visited hospitals to surface barriers to infection prevention and to share best practices and insights from successful intensive care units. Common practices led to 10 recommendations: executive and board leaders communicate the goal of zero CLABSI throughout the hospital; senior and unit-level leaders hold themselves accountable for CLABSI rates; unit physicians and nurse leaders own the problem; clinical leaders and infection preventionists build infection prevention training and simulation programs; infection preventionists participate in unit-based CLABSI reduction efforts; hospital managers make compliance with best practices easy; clinical leaders standardize the hospital's catheter insertion and maintenance practices and empower nurses to stop any potentially harmful acts; unit leaders and infection preventionists investigate CLABSIs to identify root causes; and unit nurses and staff audit catheter maintenance policies and practices.