CLABSI promise package
Central Line associated Bloodstream Infections (CLABSI) are serious infections resulting in increased length of stays and risk of mortality as well as increased cost. However, CLABSIs are preventable through proper insertion techniques and management of the central venous access device. CLABSIs can be avoided by following the best practice guidelines outlined in this Promise Package.
The CLABSI Prevention Promise Package contains helpful resources to assist staff with reducing the rate of Central Line-associated Blood Stream Infections – a strategic goal for Piedmont. The initiative originally launched in January 2017. Below we will give you a concise overview of our role in the promise package, but we highly encourage you to go more in depth. We’ve linked all the relevant documents at the end of the page.
your role as an ICU provider
A CLABSI is determined to have occurred if the CLABSI event occurs on central line day 3-5. If it occurs on day 5 or later, it is considered to be maintenance related. Central lines are assessed once per shift.
In order to achieve zero CLABSIs, our roles as a provider is -
During Insertion
Review and adhere to the insertion guidelines policy in order to follow best practices established in literature
Verify all orders for central lines are medically necessary
E.g.: vasoactive agents, hemodynamic monitoring, TPN, inability to obtain PIV, highly irritating medications, hemodialysis
Scrutinize reasons for line insertions and look for alternatives to central line placement if possible in order to limit the amount of CVLs in use
Consider alternatives such as midlines, IO device
Adhere to the insertion checklist and help w/assisting staff member during CVL insertion
Look at optimal site locations at insertion for better ongoing line maintenance. Weigh risk and benefits of location site for each patient
secure via locking device versus suturing
Maintaining Lines
Use Central Line Placement list Daily Report to monitor daily central line catheter utilization at the facility and to round on patients with central lines
Address central line necessity daily
Order central lines and blood cultures for appropriate indications
Some tools to use: Promise package, CLABSI prevention dashboard, Central line patient list daily report
