Checklists and the Ability of Intensive Care Units to Maintain Zero Central Line–Associated Bloodstream Infections

Intensive care units (ICUs) in both large and small hospitals stopped central line-associated bloodstream infections for up to 2 years after using a targeted quality improvement initiative. The initiative, known as the Comprehensive Unit-based Safety Program, or CUSP, was implemented through the Keystone Intensive Care Unit Project in Michigan hospitals.

The study, "How Long Can Intensive Care Units Maintain Zero Central Line-Associated Bloodstream Infections?" published in today's issue of the Archives of Internal Medicine found that hospital ICUs eliminated central line-associated bloodstream infections (CLABSIs) for an extended period of time—up to 2 years or more. The researchers found that 60 percent of the 80 ICUs evaluated went 1 year or more without an infection, and 26 percent achieved 2 years or more. Smaller hospitals sustained zero infections longer than larger hospitals, the researchers found.

A CLABSI is a serious healthcare-associated infection (HAI) that is introduced into the bloodstream through a central line. According to the Centers for Disease Control and Prevention (CDC), at any one point in time one in every 20 hospital patients in the United States has an HAI.

The Keystone Project used a comprehensive approach that included promoting a culture of patient safety; improving communication among ICU staff teams; and using a checklist to promote implementation of practices based on guidelines from the CDC. For more information on CUSP, go to http://www.ahrq.gov/qual/cusp.htm.