Central Line Infections in the Intensive Care Unit (ICU)

Patients in the ICU often need lines (tubes for medicine or fluids) in central (large) veins and arteries to monitor the heart and to deliver medications. These lines can sometimes become infected. According to Institute for Healthcare Improvement (IHI), there are approximately 5.3 central line infections per 1,000 catheter-days in ICUs with an 18% mortality rate. By adhering to safe practices, we have been able to significantly reduce our central line infections.

Central Line Bloodstream Infection Reduction

What does this mean?

This means that our adherence to safe practices has been effective. Our goal is to prevent all central line infections. Published benchmarks for medical and surgical patients include a mean rate according to teaching status as outlined below. Caritas has both teaching and non teaching programs.

Hospital type	Mean rate per 1000 line days
Nonteaching	1.5
Teaching	2.1

(Am J Infection Control 2009;37;783-805).

What are we doing to improve?

We want to eliminate all central line infections. Through our regular system collaborative meetings, we share best practices from each hospital. Each line is inspected for infection risks and determined how soon it can be removed. We continue to promote adherence to safe practices, including meticulous hand cleansing by care givers, proper barrier precautions when placing a line (e.g. drapes, mask, gloves), proper skin cleansing with chlorhexidine, choosing the safest choice of location for central lines and finally, daily review of the need for the line, and prompt removal of unnecessary lines. When an infection is identified, an analysis of the cause is performed immediately to identify opportunities to improve care.