Since 2001, a team approach to practice change has resulted in the implementation of quality improvement activities targeting insertion and maintenance care of invasive central venous catheters (CVCs). In 2010, CVC-BSI rates in NICU were reduced in 3 out of 4 weight categories to below the National Healthcare Safety Network (NHSN) benchmark levels. Between fall 2010 and spring 2011, surveillance of CVC-BSIs revealed 5 infection-free months. Actions are described as “care bundles,” a concept introduced by the Institute for Healthcare Improvement. Components of the CVC insertion bundle include a hand hygiene program, infection prevention staff education, standardization of catheter insertion technique, optimal site selection, chlorhexidine gluconate for skin antisepsis, formation of a dedicated CVC insertion team, standardized equipment cart for vascular access, attention to maximum sterile barrier precautions, and the removal of stopcocks and multiple-use flush solutions. Maintenance bundle activities include daily site monitoring, review of needleless connectors, “scrub the hub” 15 seconds connector care, monthly review of CVC-BSIs, and the 2-person, sterile IV tubing change done every 96 hours.
Leading Practices are submitted by health organizations from around the world. The contents of the Leading Practices library do not reflect opinions or views of HSO or its affiliates. If you have questions, concerns or suggestions please email us at email@example.com
Share your Feedback