Department of Anesthesiology; Department of Medicine, Division of Infectious Diseases and Immunology; Department of Quantitative Health Sciences
Catheters, Indwelling; Catheterization, Central Venous; Catheter-Related Infections; Bacteremia
Anesthesia and Analgesia | Anesthesiology | Bacterial Infections and Mycoses | Critical Care
Introduction: CLABSI remains a significant problem in the intensive care unit.
Hypothesis: A multimodal approach for the insertion and care of CVC will prevent CLABSI.
Methods: A Critical Care Operations Committee was formed to transform care in 8 intensive care units (ICU) in an academic medical center in 9/2004. One goal was to reduce CLABSI. Using evidence based medicine, a clinical practice guideline was developed that incorporated the use of maximum barrier precautions, chlorhexidine skin preparation, avoidance of the femoral insertion site, dedicated catheter cart, a check list, the tracking of high risk CVC, anti-septic or antimicrobial impregnated catheters, a recommendation to use ultrasound guidance when inserting CVC in the internal jugular vein, daily determination of the need for the CVC and treatment of CLABSI as a critical event.CLABSI were adjudicated by the hospital epidemiologist and CVC days were tracked. Rates of CLABSI were followed from 9/2004 through 7/2011. The Spearman correlation coefficient was used for statistical evaluation. A p
Results: CLABSI rates (per 1000 catheter-days) declined dramatically from 2004 to 2011 (p
Conclusions: A multimodal approach to CVC insertion and care reduces CLABSI by over 90%. Our ultimate goal is the complete eradication of CRBSI in our institution.
Central Line Associated Blood-Stream Infections, CLABSI, ICU, intensive care unit, critical care
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Copyright 2012 The Author(s)
DOI of Published Version
Walz J, Ellison R, Flaherty H, McIlwaine J, Mack D, Whyte K, Heard S. Effect of a multidisciplinary team approach to eradicate central venous catheter (CVC) bloodstream infections (CRBSI). Crit Care Med 2011;39 (Suppl):161.
2012 Critical Care Congress
Walz JM, Ellison RT, Flaherty H, McIlwaine J, Mack D, Whyte K, Landry K, Baker SP, Heard SO, CCOC Research Group. (2012). Effect of a Multidisciplinary Team Approach to Eradicate Central Line Associated Blood-Stream Infections (CLABSI). Anesthesiology and Perioperative Medicine Publications. https://doi.org/10.13028/bk9m-4855. Retrieved from https://escholarship.umassmed.edu/anesthesiology_pubs/123