by Sara Baker
The cardiac intensive care unit (CICU) at Johns Hopkins Bayview Medical Center reached a significant milestone on January 18, 2012—one year without a central line-associated bloodstream infection (BSI). To recognize this accomplishment, CICU nursing staff and physicians received the first Group Patient Safety Star Program Award at the Johns Hopkins Bayview Quality & Patient Safety Council meeting also held on January 18.
The CICU has been participating in a statewide collaborative effort focusing on reducing central line infections. The initial goal of the project was to reduce the number of infections statewide by 50 percent. In a 2011 to 2010 calendar-year comparison, the CICU reduced its rate by 68 percent.
Nurses and physicians took early ownership of the effort. Their focus was to ensure that the BSI bundle—a set of evidence-based measures shown to reduce central line-associated bloodstream infections—was always followed. Those measures include:
- Use of the BSI checklist during insertion of the central line
- Appropriate selection of the insertion site, avoiding femoral lines whenever possible
- Full body draping of the patient during the insertion to maintain the sterile field
- Appropriate hand hygiene for all people involved in any way with the procedure
- Gowns, gloves, masks and eye protec-tion for staff involved in the procedure
- Daily review of the need for the line, and removal when the line is no longer required
To continue the effort to reduce infections, nursing staff is empowered to stop the line insertion when there are concerns that the bundle is not being followed.