1. Central Line Bloodstream Infection Reduction
CHI Health Lakeside
Omaha, Nebraska

2. Process of Identifying Need
A dramatic increase in
CLABSI's was evident
Where was the problem?
Audits performed
CLABSI Taskforce formed 
Literature reviewed
Point prevalence studies conducted 

3. Process Improvement Methods
Staff RN's (Clinical Practice Coordinator, 3 Nursing Supervisors, Infection Prevention specialist, Operations Director, Emergency Department educator) formed CLABSI taskforce 
Employed 'Safety First' expectations of 
Having a questioning attitude
Paying attention to detail 
Stopping and Resolving 
Audits performed every shift, became very detail oriented
2 RN central line visualization upon patient arrival/transfer to unit  
Education and communication with Radiology and ER to ensure patients received same message 

4. Process Improvements Cont..
Educational pamphlet developed for patients explaining CLABSI and when to access central lines.
Changed process of central line use to 'asking to access'. 
Educated staff via mandatory skills day.
Staff was required to return demonstrate proper technique
Implemented 'phone buddies'
Changed verbiage of CHG bathing to 'treatments', mandated RN's to perform this task to reinforce 'treatment' 
Partnered with lab to use peripheral blood draws
Met with Hospital Administration and Infection Prevention Specialists to confirm plans 
Algorithm developed to assist staff in deciding when to use a central line/access a port 
Streamlined audit process 

5. Results Patients and staff embraced the changes
Hospital wide Lakeside has gone over 90 days without a CLABSI, and over 200 days without a CAUTI. 
Oncology is below the NDNQI national CLABSI mean for the first time in 2 years

6. Lessons Learned Staff buy in is essential
Explain the 'why' to staff and patients 
Education is the key to prevention 
Vigilance is necessary