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CLABSI and bundle adherence
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CLABSI and bundle adherence

Holly Simon
Master of Science (M.S.), Drexel University
18 May 2019
DOI:
https://doi.org/10.17918/00010421
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Abstract

Central line-associated bloodstream infections National Healthcare Safety Network Centers for Disease Control and Prevention Central Venous Catheter
Central venous access devices (CVADs), or central lines, are often a necessary component to the care delivery protocol to complex patient populations. The central line-associated bloodstream infections (CLABSIs) associated with the use of these devices has been related to adverse patient outcomes, and high cost for facilities. Despite advances in national goals focused on infection reduction, some facilities continue to face challenges. The National Healthcare Safety network (NHSN), developed by the Centers for Disease Control and Prevention (CDC) set benchmarks for hospital acquired infections (HAIs) so facilities could track their progress compared to national benchmarks. High rates of CLABSIs effect reimbursement, and if not addressed, could bring be financial penalties. The average cost per CLABSI in the medical progressive care unit (MPCU) at Einstein Medical Center, Philadelphia (EMCP) is presented. A review of the literature was conducted, and the evidence supports the importance of adherence to Central Venous Catheter (CVC) care and maintenance bundles. The MPCU at EMCP has a higher than benchmark rate of CLABSIs, highlighting an opportunity for improvement. The quality improvement project proposed in this paper is a gap analysis between actual practice and expected practice outlined in the organizations' approved protocol. The results demonstrate a gap in adherence with the current policy particularly with consistent, appropriate documentation of the care and maintenance of a central line. Compliance does not reach 100% in any category of CLABSI bundle adherence, evidenced by review of documentation. Seven out of sixteen categories in the bundle documentation had 0% compliance; the category that had the highest percentage of compliance with documentation was 73%. The data collected is displayed in charts and recommendations for stakeholders are provided. Keywords: CVC, CLABSI, bundle, NHSN, CDC

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