CLABSI conversations: Lessons from peer-to-peer assessments to reduce central line-associated bloodstream infections

Julius Cuong Pham, Christine A. Goeschel, Sean Berenholtz, Renee Demski, Lisa Lubomski, Michael Rosen, Melinda D. Sawyer, David Thompson, Polly Trexler, Sallie Weaver, Kristina Weeks, Peter J. Pronovost

Research output: Contribution to journalArticlepeer-review

Abstract

A national collaborative helped many hospitals dramatically reduce central line-associated bloodstream infections (CLABSIs), but some hospitals struggled to reduce infection rates. This article describes the development of a peer-to-peer assessment process (CLABSI Conversations) and the practical, actionable practices we discovered that helped intensive care unit teams achieve a CLABSI rate of less than 1 infection per 1000 catheter-days for at least 1 year. CLABSI Conversations was designed as a learning-oriented process, in which a team of peers visited hospitals to surface barriers to infection prevention and to share best practices and insights from successful intensive care units. Common practices led to 10 recommendations: executive and board leaders communicate the goal of zero CLABSI throughout the hospital; senior and unit-level leaders hold themselves accountable for CLABSI rates; unit physicians and nurse leaders own the problem; clinical leaders and infection preventionists build infection prevention training and simulation programs; infection preventionists participate in unit-based CLABSI reduction efforts; hospital managers make compliance with best practices easy; clinical leaders standardize the hospital's catheter insertion and maintenance practices and empower nurses to stop any potentially harmful acts; unit leaders and infection preventionists investigate CLABSIs to identify root causes; and unit nurses and staff audit catheter maintenance policies and practices.

Original languageEnglish (US)
Pages (from-to)67-78
Number of pages12
JournalQuality Management in Health Care
Volume25
Issue number2
DOIs
StatePublished - 2016

Keywords

  • Central line-associated bloodstream infection
  • CLABSI
  • Intensive care unit
  • Peer-to-peer assessment

ASJC Scopus subject areas

  • Health Policy
  • Care Planning
  • Health(social science)
  • Leadership and Management

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