Baylor Scott & White Health, the largest not-for-profit health care system in Texas with 48 hospitals, has developed a Central Line-Associated Bloodstream Infections (CLABSI) Prevention bundle and toolkit. The bundle and toolkit were designed in a large collaboration effort with human factors engineers and clinicians. It includes items such as a central line insertion checklist, maintenance checklists (e.g. dressing change), dressing change kits specific to line type (CVC, PICC, port and dialysis), and a CLABSI prevention maintenance bundle.
A majority of these infections, reported to the National Healthcare Safety Network by Pennsylvania acute care hospitals in 2010, occurred more than 5 days after central line insertion, which suggests that the infection occurred due to maintenance issues.1 Therefore, a CLABSI prevention maintenance bundle could play a critical role in preventing these infections.
The CLABSI prevention maintenance bundle focuses on improvements in the following areas: hand hygiene, dressings, needless connectors, hub disinfection, assessing line necessity, tubing maintenance, lab draws, decontamination, and accessing the line. The bundle not only works to improve those areas by providing recommendations, but it is also highlights the importance of documentation to ensuring compliance with prevention techniques to keep patients from developing CLABSI. The bundle focuses on the clinical worksystem, following a human factors and systems engineering framework for clinical improvement.
If you are interested in learning more about the CLABSI Prevention Toolkit or human factors in clinical settings, please contact Nanette.Myers@BSWHealth.org for more information.
1. Pennsylvania Safety Authority. Central-Line-Associated Bloodstream Infection: Comprehensive, Data-Driven Prevention. Pennsylvania Patient Safety Advisory. Sep 2011. Accessed Jul 23, 2013. http://www.patientsafetyauthority.org/ADVISORIES/AdvisoryLibrary/2011/sep8(3)/Pages/100.aspx