A statewide collaborative in Hawaii helped reduce the incidence of central-line associated bloodstream infections by 61 percent, according to a study published in the American Journal of Medical Quality and reported by the Agency for Healthcare Research and Quality.
The collaborative is modeled after the national intervention, called "On the CUSP: Stop BSI." In the intensive care unit, the intervention reminds providers to wash their hands; use chlorhexidine and full barrier precautions; and avoid using the femoral site when placing the line or cleaning it. Caregivers are also encouraged to ask every day if the line can be removed. A second level of the intervention focuses on educating staff, identifying defects and working as a team. The ultimate goal is to achieve a statewide mean BSI rate of less than 1 infection per 1,000 catheter days.
The Hawaii collaborative included 20 ICUs at 16 hospitals and 61,665 catheter days. Prior to the intervention, the overall mean BSI rate was 1.5 infections per 1,000 catheter days. Following the intervention at 16-18 months, this dropped to 0.6 infections per 1,000 catheter days, indicating a 61 percent decline.
According to the study, hospitals learned several lessons:
• Implementing this intervention involves more than just using a checklist.
• Communication among hospitals must be effective and time-sensitive.
• Leaders should recognize those involved in quality improvement efforts.
The collaborative is modeled after the national intervention, called "On the CUSP: Stop BSI." In the intensive care unit, the intervention reminds providers to wash their hands; use chlorhexidine and full barrier precautions; and avoid using the femoral site when placing the line or cleaning it. Caregivers are also encouraged to ask every day if the line can be removed. A second level of the intervention focuses on educating staff, identifying defects and working as a team. The ultimate goal is to achieve a statewide mean BSI rate of less than 1 infection per 1,000 catheter days.
The Hawaii collaborative included 20 ICUs at 16 hospitals and 61,665 catheter days. Prior to the intervention, the overall mean BSI rate was 1.5 infections per 1,000 catheter days. Following the intervention at 16-18 months, this dropped to 0.6 infections per 1,000 catheter days, indicating a 61 percent decline.
According to the study, hospitals learned several lessons:
• Implementing this intervention involves more than just using a checklist.
• Communication among hospitals must be effective and time-sensitive.
• Leaders should recognize those involved in quality improvement efforts.
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