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Medical City Arlington
central line-associated blood stream infections, quality improvement, sepsis, central venous catheters
Bacterial Infections and Mycoses | Internal Medicine | Quality Improvement
Central line associated blood stream infections (CLABSI) impart both a significant increase in mortality but also a substantial financial burden onto hospitals. Several processes have been shown to reduce the rate of CLABSIs, most of which have already been implemented at Medical City North Hills (MCNH) Hospital. Key areas of improvement are in those of compliance; namely, the implementation of a dedicated central line cart and a reminder check list to help staff. The project involved implementation of a dedicated line cart at MCNH Hospital. The cart contains supplies for placement of central lines, including trialysis catheters, and arterial lines. Supplies include: ChloraPrep, Leur Lock Caps, sterile gloves, sterile gowns, saline flushes, dressing kits, chlorhexidine BioPatches, ultrasound gel packets, sterile ultrasound probe covers, and razors. The cart also contains a check list of proper central line placement protocol. The check list acts as a reminder to both the physician placing the line and the nurse supervising the procedure. The cart is restocked on a bimonthly and as needed basis in conjunction with the restocking of the ICU supply room. This quality improvement proposal was presented to the Medical City North Hills Hospital Quality Committee. Not only were funds to purchase the proposed cart approved, funds were also allocated for a second cart for the cardiovascular ICU and 2 EZ IO (intraosseous line) kits. After carts were delivered, they were stocked and implemented in both of the hospital ICUs. Data on CLABSI rates are is still pending but anecdotally the carts have helped cut down on procedural preparation time. Evidence shows that CLABSI are a potentially preventable healthcare-associated infection. The changes presented here will hopefully not only help decrease the incidence of CLABSIs towards the goal of zero, but also help improve procedural efficiency.
HCA Healthcare Graduate Medical Education
Mangin, William; Lou, Hong; and Maldonado, David, "Decreasing rate of CLABSI at Medical City North Hills with Implementation of a “Central Line Cart”" (2023). North Texas Research Forum 2023. 20.