Purpose:

Describe the impact of Institute for Healthcare Improvement central lines bundles in decreasing central line infection. Discuss methods created and implemented for the utilization of these bundles at a metropolitan medical/surgical critical care unit.

Significance:

Implementation of Institute for Healthcare Improvement bundles in the critical care environment has improved central line outcomes.

Background/Design:

Elevated central line infection rates necessitated a root-case analysis and implementation of evidence-based practice standards.

Methods:

National Institutes of Health Services (NIHS) benchmarks were utilized. Initial data about the nature of central line infections via a Central Line Audit Tool were gathered. Interventions based on this audit included the initiation of an Insertion Safety Checklist and the development of a Central Line Necessity assessment tool.

Findings:

Eight months without a central line infection and a decrease in unnecessary lines (based on criteria) from 12% to 1-4%.

Conclusions:

Institute for Healthcare improvement guidelines, when utilized in creative ways specific to an institution's culture, can improve outcomes.

Implications for Practice:

CNSs must assess and integrate national guidelines into the existing practice environment.