title: Effectiveness of a care bundle to reduce central line-associated bloodstream infections.
abstract: OBJECTIVE
  To determine the effectiveness of a care bundle, with a novel line maintenance procedure, in reducing the rate of central line-associated bloodstream infection (CLABSI) in the intensive care unit (ICU).
  
  
  METHODS
  Before-and-after study using CLABSI data reported to the Victorian Healthcare Associated Infection Surveillance System (VICNISS), in adult patients admitted to a tertiary adult ICU in regional Victoria between 1 July 2006 and 30 June 2014. VICNISS-reported CLABSI cases were reviewed for verification. An intervention was implemented in 2009.
  
  
  METHODS
  The care bundle introduced in 2009 included a previously established line insertion procedure and a novel line maintenance procedure comprising Biopatch, daily 2% chlorhexidine body wash, daily ICU central line review, and liaison nurse follow-up of central lines.
  
  
  METHODS
  CLABSI rate (cases per 1000 central line days).
  
  
  RESULTS
  The average CLABSI rate fell from 2.2/1000 central line days (peak of 5.2/1000 central line days in quarter 4, 2008) during the pre-intervention period to 0.5/1000 central line days (0/1000 central line days from July 2012 to July 2014) during the post-intervention period.
  
  
  CONCLUSIONS
  Our study suggests that this care bundle, using a novel maintenance procedure, can effectively reduce the CLABSI rate and maintain it at zero out to 2 years.
authors.affiliation: University Hospital Geelong, Geelong, VIC, Australia. dentes@barwonhealth.org.au.
authors.forename: Damoon
authors.initials: D
authors.lastname: Entesari-Tatafi
authors.affiliation: Barwon Health, Geelong, VIC, Australia.
authors.forename: Neil
authors.initials: N
authors.lastname: Orford
authors.affiliation: Monash University, Melbourne, VIC, Australia.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Bailey
authors.affiliation: Barwon Health, Geelong, VIC, Australia.
authors.forename: Martina N I
authors.initials: MN
authors.lastname: Chonghaile
authors.affiliation: Barwon Health, Geelong, VIC, Australia.
authors.forename: Jill
authors.initials: J
authors.lastname: Lamb-Jenkins
authors.affiliation: Barwon Health, Geelong, VIC, Australia.
authors.forename: Eugene
authors.initials: E
authors.lastname: Athan
mesh_terms: D000328:Adult; D000368:Aged; D001315:Australia; D016470:Bacteremia / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D055499:Catheter-Related Infections / Q000453:epidemiology / Q000382:microbiology / Q000517:prevention & control*; D002405:Catheterization, Central Venous / Q000009:adverse effects*; D002985:Clinical Protocols; D065187:Controlled Before-After Studies; D003422:Critical Care; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D064872:Patient Care Bundles