High-Performance Work Practices in CLABSI Prevention Interventions

Table 3. Types of HAI Prevention Activities

Final Report: Executive Summary (continued)

Focus Activities
Clinical improvements
  • Standards for line insertion (e.g., checklists, sterile barrier precautions, avoidance of femoral line).
  • Standards for line maintenance (e.g., schedule for dressing changes, "scrub the hub,"* use of chlorhexidine, biopatch, specialized lines/tubing).
  • Routine assessment of line necessity.
  • Adoption of new/better products for infection prevention.
  • Hand-washing initiatives.
Process improvements
  • Structured improvement processes (e.g., committee structure, root-cause analyses, learning from defects).
  • Use of standardized line carts. 
  • Multidisciplinary rounds and safety huddles.
Organizational improvements
  • Strong leadership at multiple levels. 
  • Focus on improving culture (e.g., emphasis on patient safety, transparency, improvement orientation, nurse empowerment). 
  • Visible identification of CLABSI prevention as a goal/priority. 
  • Widespread communication of CLABSI rates (e.g., posted on units, on screensavers). 
  • Rewards and recognition for CLABSI prevention. 
  • Empowerment of nurses and other staff to stop procedures if protocols are not followed. 
  • Enhanced efforts to monitor and report rates; compliance with protocols.

Key: CLABSI = central line–associated bloodstream infection; HAI = healthcare-associated infection.

* "Scrub the hub" refers to cleaning the hub of a central line prior to use. For examples of materials used to promote this practice, go to http://www.ihi.org/resources/Pages/Tools/ScrubtheHubPosters.aspx.

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Page last reviewed August 2015
Page originally created August 2015
Internet Citation: Table 3. Types of HAI Prevention Activities. Content last reviewed August 2015. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/professionals/quality-patient-safety/cusp/clabsi-hpwpreport/clabsi-hpwptab3.html