Aggressive training led to 35% drop in central-line infections

Coordinated education and enforcement efforts led to a 35 percent reduction in central line-associated bloodstream infections (CLABSI) at more than 350 hospital ICUs nationwide, according to initial data just released by the Agency for Healthcare Research and Quality (AHRQ).

The project's core clinical interventions were hardly revolutionary: They included such basic tenets as handwashing, use of full-barrier protections while inserting central venous catheters, use of chlorhexidine to clean insertion sites, avoidance of the femoral artery and removal of unnecessary catheters.

But the program paired these proven techniques with aggressive training campaigns, including quizzes, videos, slides and daily goal sheets, officials say. They also provided toolkits and frequent reminders -- physicians discussed removing unneeded catheters during rounds, for example -- to ensure staff members were compliant with the recommended interventions.  

The result: Participating hospitals reduced CLABSI rates from an average of 1.8 infections per 1,000 central line days to an average of 1.17 infections per 1,000 central line days, AHRQ data shows. More data is expected later this year -- a total of 1100 hospitals in 45 states are participating in the project.

"This program worked because we kept score with a measure clinicians believed was valid, we were guided by science, and we worked together - federal, state and local providers," Peter Pronovost, who oversees the program, told the Wall Street Journal. "Let's ensure that all hospitals eliminate these infections and that we develop a pipeline of new programs to reduce other types of preventable harm."

The AHRQ's data comes on the heels of a CDC report last month showing an overall decline in central line infections by 60 percent over the past eight years. Some of the same interventions in other programs such as On the CUSP were noted as effective.

CDC officials indicate that the need now is to extend programs like this beyond the ICU to other areas like dialysis units, where central lines are often inserted and maintained.

For more information:
- Access information directly from AHRQ
- Visit the program's website
- Read this article in the Wall Street Journal