Implementing Central Line Necessity Tracking Tool in an Intensive Care Unit
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Daniel, Soneya G.
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Abstract
Problem and Purpose: A 30-bed adult intensive care unit (ICU) in a community hospital reported four central line-associated bloodstream infections (CLABSI) in 2023 and four CLABSIs in the first quarter of 2024. A root cause analysis identified prolonged dwell time and delayed removal as primary contributing factors. This quality improvement project (QIP) aimed to reduce the CLABSI rate among adult critically ill patients in the ICU by implementing and measuring the completion of a Central Line Necessity Tracking Tool (CLNTT) in daily rounds. Methods: The implementation process over 16 weeks in the Fall of 2024 included 100% staff education on the CLNTT, nurses screening for the necessity of the central line using the CLNTT with the provider in daily rounds, and provider documentation of the central line necessity, discontinuation, or alternative plan in the electronic health record. Results: A goal of 100% staff and provider education was achieved, and an average of five central lines were removed weekly. Average CLNTT compliance was only 65%. One CLABSI was reported in the week two. Conclusion: A validated tool assessing the need for continued central lines in daily rounds can objectively assess the need for central lines and promote prompt removal. The addition of a smart phrase on central venous catheter (CVC) documentation to provider notes is highly recommended.