Success stories
The United Hospital Fund in collaboration with the Greater New York Hospital Association engaged 38 New York hospitals in a quality-improvement initiative to reduce the number of CABSIs in intensive care units in 2007. The hospitals were able to reduce CABSIs in their ICUs by 70%. This reduction has been sustained over a two-year period.23 A collaborative of children’s hospitals was able to reduce CABSI by 43%, prevent an estimated 275 infections, save $9 million, and prevent an estimated 40 deaths by adhering to recommendations for CABSI prevention such as appropriate hand hygiene, maximal barrier precautions, use of chlorhexidine skin antiseptic, correct line placement, and daily assessment.24 A cohort of hospitals in Michigan participated in a collaborative over 18 months to reduce CABSI that resulted in a decrease from 2.7 at baseline to 0 at 3 months post-intervention. The intervention was comprised of hand hygiene, full-barrier precautions during catheter insertion, disinfection of the catheter site with chlorhexidine, avoidance of the femoral site, and removal of unnecessary catheters. These efforts resulted in up to 66% reduction in CABSIs throughout an 18-month period.25

Getting to zero may be difficult, but it is achievable, as these hospitals have demonstrated. There are numerous stories of healthcare organizations that have achieved zero or significantly reduced CABSIs. By standardizing practices, following the recommended guidelines, and providing education, training, and feedback to healthcare workers involved in catheter placement and care, a zero infection rate is possible.