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Reducing CLABSI Rates by Use of Needleless Connectors and Technology Based Bundles
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(June 5, 2020)
     

CLABSI is a primary Laboratory Confirmed Bloodstream Infection in a patient with a central line at the time of (or within 48-hours prior to) the onset of symptoms and the infection is not related to an infection from another site. CLABSIs are serious infections typically causing a prolongation of hospital stay and increased cost and risk of mortality. CLABSI can be prevented through proper insertion techniques and management of the central line. A quality-improvement intervention (ACCESS), including Education, Central Venous Catheter (CVC) insertion and maintenance bundle, use of needleless connectors , scrubbing the hub, and process surveillance were introduced. Outcome surveillance including CLABSI per 1,000 catheter-days was measured. During this 9-month period, the rate of CLABSI significantly declined from more than 6 per 1000 catheter-day during the preintervention period to zero per 1000 catheter-day post-intervention period in the months of July and August. The Hand hygiene rates increased from 45% (April) to 89% (June) to 91% (December). Flushing practices increased from 45% to 85% in the same time period. The scrubbing of the hub practice, which was nonexistent, increased to 25% & finally to 70%. The avoidance of femoral site to minimize infection also increased from 30% to 92%. The overall compliance with the care bundles increased to 86%. This multidisciplinary infection control intervention can effectively reduce the rate of CLABSI. The impact of different care bundle varies, and use of needless connectors and trained manpower is an essential component of the care line insertion and maintenance bundle.

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