PURPOSE: To assess the long term impact of a coordinated ongoing performance improvement project on the rate of intensive care unit (ICU) central line associated blood stream infections (CLABSI).
METHODS: A dedicated ICU performance improvement team meets monthly to address quality issues that impact ICU patients. CLABSI is a monthly agenda item that is continually addressed using the Plan Do Study Act (PDSA) cycle. Surveillance criteria for identifying CLABSI are from the National Healthcare Safety Network (NHSN). Outcome data are reported quarterly. Five major process improvement programs have been implemented since 2004. Due to long term surveillance and reporting, we recently revised our graphs to report our results annually for the first four years and then quarterly since 2008.
RESULTS: Central line associated blood stream infections were above National Nosocomial Infections Surveillance system (NNIS) benchmark 5.0 in 2004 at 8.5 BSI’s per 1,000 line days. Five distinct and sequential performance improvement initiatives have been implemented to address this problem since that time. As of Quarter 1 2010 there were no catheter-related bloodstream infections in the Baystate Medical Center ICU.
CONCLUSION: An ICU specific performance improvement project related to reduction in CLABSI delivers durable results that are further impacted by continuous application of the PDSA cycle. Continuous performance improvement can be achieved through this methodology in the ICU.
CLINICAL IMPLICATIONS: Elimination of central line associated bloodstream infections through application of continuous performance improvement using PDSA methodology improves patient safety. Sequential projects can result in optimal performance within the ICU environment.
DISCLOSURE: William Mc Gee, No Financial Disclosure Information; No Product/Research Disclosure Information