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How-to Guide: Prevent Central Line-Associated Bloodstream Infection
This How-to Guide describes key evidence-based care components of the IHI Central Line Bundle which has been linked to prevention of central line-associated bloodstream infections, describes how to implement these interventions, and recommends measures to gauge improvement.
Changes to Prevent Healthcare-Associated Infections
Organizations must test and implement changes to existing processes in order to prevent healthcare-associated infections (HAIs).
Using Care Bundles to Improve Health Care Quality
This IHI white paper describes the history, theory of change, design concepts, and outcomes associated with the development and use of bundles — a small set of evidence-based interventions for a defined patient population and care setting — and reflects on learning over the past decade.
Profiles in Improvement: Katharine Luther, Vice President, IHI
IHI Vice President Kathy Luther describes her career in health care quality improvement, and how her current IHI work includes getting finance and clinicians to work together to impact cost and quality.
How-to Guide: Prevent Central Line-Associated Bloodstream Infection (Rural Hospital Supplement)
This How-to Guide is specifically tailored for rural hospitals and describes key evidence-based care components for preventing central line-associated bloodstream infections, describes how to implement these interventions, and recommends measures to gauge improvement.
Applying Toyota Production System Principles in a Critical Care Unit
Virginia Mason Medical Center tested and adapted Toyota Production System principles in its Critical Care Unit, leading to more highly reliable and safer bedside care.
Reducing Average Length of Stay on Mechanical Ventilation Using Bundles and Mobility
University of Rochester Medical Center targeted specific elements in the Ventilator and Central Line Bundles to increase compliance, thereby reducing ventilator-associated pneumonia, reducing CRBSIs, and decreasing average length of stay. In addition, a mobility initiative helped the team achieve daily sedation interruption and development of a new bundle further reduced CRBSIs.
Improving ICU Care: Reducing Complications from Ventilators and Central Lines
To improve safety and reduce complications in the ICU, Cape Coral Hospital focused on improving communication using multidisciplinary rounds and eliminating VAP and CL-BSI. The result was a significant decrease in these hospital-acquired infections as evidenced by 17 months without a VAP and 19 months without a CL-BSI.
Decreasing Harm to Patients by Standardizing Care
Northeast Health decreased harm to patients by standardizing care, including implementation of the Central Line and Ventilator Bundles and formation of a Rapid Response Team.
Saving Lives: Simple Interventions DO Really Help in the ICU
PeaceHealth/St. Joseph Hospital implemented the Ventilator and Central Line Bundles, resulting in 4+ months without a ventilator-associated pneumonia and 3+ months without a central line infection.
Leveraging IHI Participation to Achieve Critical Care Improvement Spread in a Multi-Hospital System
A system-wide Critical Care Collaborative was convened by Catholic Healthcare West (San Francisco, California, USA) modeled after the IHI Breakthrough Series Collaborative to achieve improvements in care systems in the intensive care setting resulting in reduction in ventilator-associated pneumonia rate, reduction in our catheter-related blood stream infection rate, improved compliance with all components of the ventilator bundle, reduction in ICU average length of stay, and reduction in percentage of patients in the ICU greater than 7 days.
When It Comes to Clinical Quality, Everybody Makes the Team
When it comes to improving clinical quality and providing the best patient care, every hospital employee and every department plays a role. When you engage non-clinical staff in quality improvement, teams get stronger and patients benefit.
Reducing Hospital-Acquired Infections in a Long-Term Acute Care Hospital
Windy Hill Hospital (Marietta, Georgia, USA) has significantly reduced the number of hospital-acquired infections caused by MRSA, VRE, and C. difficile by implementing admission surveillance cultures and improving hand hygiene, among other improvements.
Six Sigma Approach to Reduction of Central Venous Catheter-Related Bloodstream Infections
Florida Hospital reduced the overall BSI rate by more than 40 percent and decreased the number of adult central venous catheter-related BSIs by more than 20 percent with the introduction of a custom tray that includes maximal barrier precautions, 2 percent chlorhexadine with alcohol skin prep, and an antimicrobial catheter.
Reducing Healthcare-Associated MRSA Infections on a Surgical Unit
St. John's Regional Health Center (Springfield, Missouri, USA) reduced hospital-acquired infections through their work in an IHI Learning and Innovation Community
Understanding Bundles: An IHI Faculty Conversation
IHI faculty for the Rethinking Critical Care seminar discuss and try to clarify some important and often misunderstood points about implementing care bundles (such as the Ventilator Bundle and the Central Line Bundle).
What Zero Looks Like: Eliminating Hospital-Acquired Infections
As much as public awareness of the problem has grown, most patients might still be surprised to learn that infections contracted during a hospital stay are a significant cause of death in the US. Learn how hospitals have significantly reduced their monthly hospital-acquired infection rates, some down to zero.
Effect of Nonpayment for Preventable Infections in US Hospitals
This study examined rates of healthcare-associated infections deemed preventable by the Centers for Medicare & Medicaid Services, such as catheter-associated bloodstream infections, catheter-associated urinary tract infections, and ventilator-associated pneumonias.
Measures: Prevent Central Line Infection
Care teams should measure each of the evidence-based interventions recommended by the How-to Guide: Prevent Central Line Infection.
Reduction in central line-associated bloodstream infections among patients in intensive care units: Pennsylvania, April 2001-March 2005
This article discusses the reduction in central line-associated bloodstream infections among patients in intensive care units.
Annotated Bibliography for Preventing Central Line-Associated Bloodstream Infections
This annotated bibliography presents selected literature for the elements of the IHI Central Line Bundle and prevention of central line-associated bloodstream infections.
A controlled trial of scheduled replacement of central venous and pulmonary-artery catheters
Controlled trial in adult ICU patients requiring central venous or pulmonary artery catheters for more than three days.
Risk of infection due to central venous catheters: Effect of site of placement and catheter type
Prospective observational study or the risk factors for colonization of catheters and of catheter-related bloodstream infection over 28 months of all non-tunnelled central venous catheters on medical-surgical wards of a VA hospital.
Prospective randomised trial of povidone-iodine, alcohol, and chlorhexidine for prevention of infection associated with central venous and arterial catheters
Randomized controlled trial on a surgical ICU in which 668 catheters were placed with either 10 percent povidone-iodine, 70 percent alcohol, or 2 percent aqueous chlorhexidine disinfection of the site prior to insertion and every other day thereafter.
Complications of femoral and subclavian venous catheterization in critically ill patients: A randomized controlled trial
Randomized controlled trial in 289 adults requiring a first central venous catheter, randomized to femoral or subclavian site.