P2.287: Quick Reduction of CLABSIs in a Pediatric Cardiac Intensive Care Unit

Purpose/Objectives: Central line associated blood stream infections (CLABSIs) are preventable events, are a major source of hospital acquired infections and are associated with increased morbidity, mortality, and costs. Successful CLABSI reduction requires more than bundle implementation; it requires changes in behavior of healthcare professionals. This change in behavior can be accomplished through education, performance assessments, feedback, teamwork, and implementation of an overall safety culture. The objective of this quality improvement project was to reduce the incidence of CLABSIs in a pediatric cardiothoracic intensive care unit (CTICU) after an increase in events in 2023 with the implementation of proactive CLABSI reduction strategies and reinforcement of safety-first culture.

Design/Methods: An increase in the CLABSI rate in the CTICU from 0.24 per 1000 central line days in 2022 to 1.45 per 1000 central line days in 2023 led to the following proactive CLABSI reduction strategies: (1) increase in leadership rounds (July 2023); (2) sequential cleaning, sterile towel and sterile stopcock cap change for ECMO team (August 2023); (3) CLABSI simulation added to traveler yearly competencies (August 2023); (4) bare nail policy (Sept 2023); (5) environmental surface cleaning check list (Sept 2023); (6) AccuPoint® Advanced surface testing (Sept 2023); (7) parent panel perspective (Oct 2023); (8) proactive CLABSI safety huddle (Nov 2023); (9) CLABSI bingo (Nov 2024). These interventions were in addition to the CLABSI bundle already in use.

Results: There was a reduction in CLABSI rate from 1.45 per 1000 central line days in 2023 to 0.44 per 1000 central line days in 2024. CLABSI bundle compliance K cards were completed during leadership rounds bimonthly with a compliance rate of 87% in 2023 and 85% in 2024. Surface cleaning checklists were reviewed monthly, with a compliance rate of 80% from September 2023 through August 2024.

Conclusion/Discussion: The addition of proactive CLABSI reduction strategies were successful in quickly reducing the CLABSI rate in our CTICU. Commitment to quality improvement, transparency, accountability and reinforcement of the safety-first culture will likely result in sustained improvement in CLABSI reduction.