Multi-Pronged Approach Eliminates Central Line-Associated Bloodstream Infections

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Central line-associated bloodstream infections (CLABSI) fell by more than 90 percent during the past three years at the Hospital of the University of Pennsylvania due to a multi-pronged approach combining leadership initiatives, electronic infection surveillance, checklists to guide line insertion and maintenance, and implementation of the Toyota Production System to encourage best practices in line care. The findings, which Penn physicians say provide a road map for cutting the deadly, costly toll of hospital-acquired infections nationwide, were presented March 20 at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA).

"We were only able to see a sustained reduction in infections when we took a multifaceted approach throughout the entire hospital. There are many procedures, many steps and many personnel that are involved in the placement, care and maintenance of central venous catheters. We have learned that a successful program to reduce CLABSI must take all of these factors into consideration," says Neil Fishman, MD, director of healthcare epidemiology and infection prevention and control at the 735-bed Philadelphia hospital and president-elect of SHEA. "Central line-associated bloodstream infections can add up to $40,000 to the cost of a hospitalization and take their toll in human lives. The mortality rate of CLABSI has been reported as high as 30 percent. Our program ultimately makes the hospital a safer place to receive medical care."

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