Dedicated CLABSI prevention registered nurse role
Abstract:
Background: Following a 200% increase in the Central line associated bloodstream infection (CLABSI) Standardized Infection Ratio (SIR) in a private teaching hospital between 2019 and 2020, a program with the utilization of a CLABSI Prevention Registered Nurse (PR-N) was implemented to reduce CLABSIs through a variety of focused prevention efforts and education.
Methods: The CLABSI P-RN project consisted of a dedicated team of RNs that performed interventions which included audit of all central lines daily, real time education and remediation, bi-weekly educational handouts, and assistance with 2-person dressing changes. Audit data was utilized to identify trends in gaps in compliance to the CLABSI bundle (i.e., daily bathing, dressing integrity). The CLABSI rate/1000 central line days was tracked in pre-intervention, intervention and post-intervention time periods.
Results: During the intervention, the CLABSI rate decreased from 1.4 during the pre-intervention time period, to 0.4 during the intervention time period (p-value 0.04). Additionally, daily bathing compliance improved from 84.3% during the pre-intervention time period, to 90.8% during the intervention time period (p-value 0.004).
Discussion: The implementation of the CLABSI P-RN was beneficial in reducing CLABSIs.
Conclusions: An expert trained role dedicated to central line management reduces CLABSI occurrences, reduces healthcare costs, and improves patient outcomes.
Reference:
Star KE, Lindsey K, Reese SM, Paulino L, Hernandez LL, Tynes I, Eiseman K, Tynes J. Reducing central line-associated bloodstream infection with a dedicated CLABSI Prevention Registered Nurse role. Am J Infect Control. 2023 Dec 5:S0196-6553(23)00823-4. doi: 10.1016/j.ajic.2023.11.021. Epub ahead of print. PMID: 38061403.