AIM: To improve the rates of central line-associated bloodstream infections in an intensive care and non-intensive care setting in a large Australian health service. DESIGN: Evidence-based care bundles targeting central line practices were developed and implemented using a pragmatic action research-approach. METHODS: Wards recruited change facilitators to implement the bundles. Compliance and ward engagement were measured, and pre-intervention and intervention central line-related infection rates were compared. RESULTS: Wards showed a reduction in central line-related infections by 90% during the intervention for up to 2 years. Adherence to bundles was high in both settings. Improvements in insertion practices were observed after baseline and were sustained, with the largest improvement seen in documentation. Maintenance and removal practices showed less variation than insertion practices. CONCLUSION: Care bundles are an effective intervention to reduce central-line-related infections over a sustained period when clinician adherence is high. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Care bundles can be effective in high-risk settings beyond intensive care units, including haemodialysis. IMPACT: Central lines were identified from local hospital data as a major contributor to health care-associated infection rates. Care bundles were implemented in high-risk settings and demonstrated sustained reductions in central-line-related infections. Care bundles are an effective intervention for health care organisations to reduce and sustain preventable infections in high-risk patient cohorts. REPORTING METHOD: We adhered to the Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0) framework. PATIENT OR PUBLIC CONTRIBUTION: No patient or public contribution.
Tuqiri et al. (Thu,) studied this question.