A Team Approach to Decreasing Clabsi Rates in a Bmtu

A Team Approach to Decreasing CLABSI Rates in a BMTU Abstract #5085 Topic Significance & Study Purpose/Background/Rationale: Prolonged neutropenia and mucosal barrier breakdown are major treatment related toxicities contributing to central line associated blood stream infections (CLABSIs) in bone marrow transplant recipients.  CLABSIs are preventable, costly, and potentially deadly.  Bone Marrow Transplant nurses have the ability to reduce the number of CLABSIs through a variety of techniques and practices. Methods, Intervention, & Analysis: An evaluation of current practice and areas for improvement were identified which led to the development of a comprehensive unit based safety program (CUSP) team.  A “Back to Basics Campaign” was initiated by the team that included proper hand hygiene, aseptic techniques when accessing central lines, environmental practices, and blood culture procedure techniques.  Additionally, there were specific nurse and patient education, environmental practices (i.e., high-touch surface infection control, decreasing clutter in recipient rooms, ultra violet light decontamination cleaning, isolation practice changes), and CLABSI drill downs by the clinical nurse leader and team. CLABSI rates were measured before and after implementation of education and clinical practice changes. The overall goals were to improve patient outcomes and reduce CLABSI rates below national benchmark. Compliance audits were performed weekly by nursing leadership to validate nurse and patient practices.  Findings & Interpretation: CLABSI rates prior to implementation were 9.938 and three months after the interventions were 2.42.  Mucosal barrier infections were unpreventable and included in the data. Discussion & Implications: Staff engagement is essential in hospital efforts and evidence-based practices to improve quality of care for optimal patient outcomes. Nursing leadership is instrumental in providing structure, consistency, and specific feedback on progress as well as real time CLABSI rates to the team. CLABSIs are common and can be fatal in the transplant population. Continued surveillance of techniques and practices learned are on-going and monitored for compliance.  Improvements in all aspects of nursing care with meticulous infection control techniques and environmental monitoring is essential for improved patient outcomes and reducing CLABSI rates in a bone marrow transplant population.