title: Implementing a better bundle to achieve and sustain a zero central line-associated bloodstream infection rate.
abstract: The objective of every health care facility is achieving and maintaining a zero central line-associated bloodstream infection (CLABSI) rate. Interventions to enhance care were put into place, and changes in CLABSI rates were tracked. Data were collected from January 2003 through June 2009. The interventions included the following: a dedicated vascular access team; swabbable clear positive displacement needleless connector; chlorhexidine-impregnated disk; flushing with 20 mL of normal saline; rigorous central line care education; increased use of peripherally inserted central catheters; and daily review of necessity. A significant drop to zero CLABSIs occurred after the introduction of several new central line care practices.
authors.affiliation: VA Puget Sound Health Care System, Seattle, Washington 98108, USA. we2frogs@oz.net
authors.forename: Timothy
authors.initials: T
authors.lastname: Royer
mesh_terms: D000891:Anti-Infective Agents, Local / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002408:Catheters, Indwelling / Q000009:adverse effects*; D002710:Chlorhexidine / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease / Q000517:prevention & control; D017053:Infection Control / Q000379:methods* / Q000592:standards; D015403:Nursing Evaluation Research; D018805:Sepsis / Q000451:nursing / Q000517:prevention & control*; D012965:Sodium Chloride / Q000008:administration & dosage / Q000627:therapeutic use; D013223:Statistics as Topic; D014861:Washington
chemical_list: D000891:Anti-Infective Agents, Local; D012965:Sodium Chloride; D002710:Chlorhexidine