Introduction: Central Line-Associated Bloodstream Infections (CLABSIs) are preventable yet remain a major source of patient harm and hospital costs, increasing length of stay by up to 10 days and adding over 45, 000 per case. Community hospitals often face unique challenges in sustaining best practices compared to larger academic centers. Methods: Saint Agnes Medical Center launched a year-long multidisciplinary QI project (Jan–Dec 2024) using the Plan-Do-Study-Act model. Interventions included simulation-based inserter training, standardized insertion checklists, and a nurse-led “stop-the-line” policy. Midline catheter use increased as a first-line alternative when appropriate, and external jugular access was adopted by the crisis team. Peripheral vasopressors were introduced using evidence-based protocols with close monitoring for complications such as limb ischemia. Maintenance bundles included CHG bathing, dressing change competency, and daily line necessity reviews. Transparency was supported via unit-level dashboards, monthly feedback, and incentive-based recognition. Results: Total CLABSIs declined from 22 to 8 (64%), and central line days dropped 15%. The hospital-wide standardized infection ratio (SIR) improved from 1. 24 to 0. 83 (95% CI: 0. 31–1. 46). In the ICU, CLABSIs fell from 14 to 3 (79%), with a line day reduction of 24%. The ICU SIR improved from 1. 81 to 0. 51 (95% CI: 0. 00–1. 18), significantly outperforming national benchmarks. The introduction of midlines and peripheral vasopressors contributed to reduced central line use while maintaining patient safety. Conclusions: This project demonstrates that community hospitals can achieve substantial reductions in CLABSI through low-cost, multidisciplinary interventions focused on standardization, empowerment, and evidence-based vascular access. These strategies are scalable and align with national guidelines to enhance patient safety.
Clark et al. (Sun,) studied this question.