Developing a Low-Cost Solution to a High-Risk Problem: Reducing Central Line-Associated Blood Stream Infections

NuHealth Nassau University Medical Center identified central line-associated blood stream infection as a focus for corporate process improvement. Senior leaders reallocated existing resources for a robust performance improvement effort. Leadership worked collaboratively to identify improved procedures for insertion and maintenance of central lines and improved monitoring of patient safety risks. A dedicated team, the Division of Transformation, was charged with the development, implementation, and monitoring of an initiative to transform the process of care to reduce central line infections. DOT served as the communication hub regarding central line safety, linking information among key caregivers. Five components of central line care were determined to be critical: staff competency, appropriateness of central venous catheter site, duration of CVC line, access for blood draws, and line maintenance. The DOT team assessed compliance with 29 predetermined criteria, communicating this information to the bedside practitioners, medical director, and senior vice president of nursing. Information was provided real-time to ensure evidence-based guidelines were followed. Nursing was empowered at the bedside to ensure maintenance of sterility during the insertion procedure. Accountability was shared through improved education, communication and leadership involvement.