title: Successful implementation of a unit-based quality nurse to reduce central line-associated bloodstream infections.
abstract: BACKGROUND
  Central line (CL)-associated bloodstream infections (CLABSI) are an important cause of patient morbidity and mortality. Novel strategies to prevent CLABSI are needed.
  
  
  METHODS
  We described a quasiexperimental study to examine the effect of the presence of a unit-based quality nurse (UQN) dedicated to perform patient safety and infection control activities with a focus on CLABSI prevention in a surgical intensive care unit (SICU).
  
  
  RESULTS
  From July 2008 to March 2012, there were 3,257 SICU admissions; CL utilization ratio was 0.74 (18,193 CL-days/24,576 patient-days). The UQN program began in July 2010; the nurse was present for 30% (193/518) of the days of the intervention period of July 2010 to March 2012. The average CLABSI rate was 5.0 per 1,000 CL-days before the intervention and 1.5 after the intervention and decreased by 5.1% (P = .005) for each additional 1% of days of the month that the UQN was present, even after adjusting for CLABSI rates in other adult intensive care units, time, severity of illness, and Comprehensive Unit-based Safety Program participation (5.1%, P = .004). Approximately 11.4 CLABSIs were prevented.
  
  
  CONCLUSIONS
  The presence of a UQN dedicated to perform infection control activities may be an effective strategy for CLABSI reduction.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD. Electronic address: kthom@epi.umaryland.edu.
authors.forename: Kerri A
authors.initials: KA
authors.lastname: Thom
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Shanshan
authors.initials: S
authors.lastname: Li
authors.affiliation: University of Maryland Medical Center, Baltimore, MD.
authors.forename: Melissa
authors.initials: M
authors.lastname: Custer
authors.affiliation: University of Maryland Medical Center, Baltimore, MD.
authors.forename: Michael Anne
authors.initials: MA
authors.lastname: Preas
authors.affiliation: University of Maryland Medical Center, Baltimore, MD.
authors.forename: Cindy D
authors.initials: CD
authors.lastname: Rew
authors.affiliation: University of Maryland Medical Center, Baltimore, MD.
authors.forename: Christina
authors.initials: C
authors.lastname: Cafeo
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Surbhi
authors.initials: S
authors.lastname: Leekha
authors.affiliation: Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD.
authors.forename: Brian S
authors.initials: BS
authors.lastname: Caffo
authors.affiliation: University of Maryland School of Medicine, Program in Trauma, Baltimore, MD.
authors.forename: Thomas M
authors.initials: TM
authors.lastname: Scalea
authors.affiliation: University of Maryland School of Medicine, Program in Trauma, Baltimore, MD.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Lissauer
mesh_terms: D000328:Adult; D055499:Catheter-Related Infections / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D006801:Humans; D017053:Infection Control / Q000379:methods* / Q000458:organization & administration*; D007362:Intensive Care Units; D009726:Nurses; D011786:Quality Control; D011787:Quality of Health Care
keywords: CLABSI; Patient safety