Central line insertion bundle: experiences and challenges in an adult ICU

• Published in: Nursing in critical care Vol. 17; no. 3; pp. 123 - 129
• Main Authors: McPeake, Joanne, Cantwell, Shelia, Malcolm G, Booth, Malcolm, Daniel
• Format: Journal Article
• Language: English
• Published: Oxford, UK Blackwell Publishing Ltd 01-05-2012
• Subjects: Adult; Adult intensive care; Bacteremia - etiology; Bacteremia - prevention & control; Catheter-Related Infections - microbiology; Catheter-Related Infections - prevention & control; Catheterization, Central Venous - adverse effects; Catheterization, Central Venous - methods; Catheterization, Central Venous - standards; Change management; Checklist - utilization; Critical Care - methods; Disinfection - methods; Documentation - methods; Effectiveness of health care intervention; Efficiency, Organizational; Evidence-Based Medicine; Hospitals, Urban; Humans; Interprofessional Relations; Nursing; Outcome and Process Assessment (Health Care) - methods; Patient Safety - standards; Practice development; Preoperative Care - methods; Program Development; Protective Devices; Quality improvement; Quality Improvement - standards; Reproducibility of Results; Scotland; Scotland; United Kingdom > UK
• ISSN: 1362-1017; 1478-5153
• DOI: 10.1111/j.1478-5153.2012.00491.x

Background: Central venous catheters are used frequently in the intensive care unit (ICU). However, there is an associated morbidity, mortality and cost derived from their infectious and mechanical complications. The Scottish Patient Safety Programme (SPSP) has developed a multi faceted care bundle, with the aim of reducing catheter‐related blood stream infections.
Aim: This paper aims to identify and describe the experience and challenges in implementing the SPSP central line insertion bundle in one adult ICU, in a large inner city teaching hospital.
Interventions:‘Plan‐Do‐Study‐Act' cycles, checklists for insertion and a standardized trolley were adopted to implement the central line insertion bundle in clinical practice.
Conclusion/Implications: Improving the reliability of the central line insertion bundle has reduced infections. Key steps in the process were setting clear aims and ensuring staff understand the change process and measurement of results. This is fundamental to the success of any quality improvement process.