Improve the Risk of Central Line-Associated Bloodstream Infections with Central Line Dressing Changes through a Team Approach

Abstract

Practice Problem: Central Line Associated Bloodstream Infections (CLABSI) are a preventable hospital acquired infection which contributes to patient morbidity, mortality and rising healthcare costs. PICOT: The PICOT question that guided this project was: In adult inpatients with central venous catheters, does the use of a two-person dressing change team, compared to a single person procedure, decrease the rate of central line associated bloodstream infections over the course of 8 weeks? Evidence: The prevention of CLABSI is most effective when multifaceted line maintenance bundles are implemented and adherence to these bundles nears 100% (Schreiber et al. 2018). Intervention: A two-person, evidence-based dressing change procedure was implemented for all central line dressing changes, known as the sterile buddy. The role of this additional bedside nurse was to assist the dressing change through an extra set of hands and to provide real-time sterile technique feedback to the primary nurse. Outcome: The intervention did not lead to a statistically significant change in the rate of CLABSI, however there was a reduction in the overall number of observed CLABSI compared to both the prior year and the 6 months preceding to the intervention. Conclusion: The implementation of a sterile buddy was an effective intervention that resulted in a decline in the total of CLABSI, and although not statistically significant, resulted in an estimated cost savings of $56,000 when compared to the year prior and an estimated cost savings of $112,000 when compared to the 6 months preceding the intervention.