During this pilot, the MICU was able to achieve 188 days between events which was above the three sigmas upper control limit of 111.2 days. The MICU was also able to reduce its average CLABSI rate per 1,000 central line days for 2022 to 0.94. Having everything you need at the moment to complete a task is always a timesaver. This same concept can also become a lifesaver when it comes to blood culture collection technique and identification of a Central Line-Associated Bloodstream Infection (CLABSI). The nursing team in an Academic Medical Center Medical ICU (MICU) was able to standardize their blood culture collection technique, and having it ‘all in the bag’ contributed to a statistically significant increase in days between CLABSI events.
Problem: Central Line Associated Blood Stream Infections (CLASBI) are among the most costly and deadly hospital-acquired infections (Clarkson, 2020). Lack of standardization of blood culture kits may contribute to false positives. Prior to this pilot, the MICU averaged 29 days between CLABSI events with an average rate of 2.42
Measurement: To determine the effectiveness of the practice change, the team monitored days between central line infections and the rate of CLABSI per 1,000 central line days. Both of these metrics were tracked on a Six Sigma control chart to monitor for statistically significant changes
Analysis: A Six Sigma control chart was utilized to monitor the days between infections and the rate of CLABSI per 1,000 central line days. This data was monitored for signals such as astronomical values, shifts, and/or trends
Implementation: The team utilized the PDSA model for improvement to implement a kit that contained all the contents and point-of-use education for blood culture collection. Nursing provided feedback on alternative products as the team faced supply chain challenges. This kit provides standardization when the nursing workforce is constantly changing
