(59) Bundling Up Against CLABSI: The Compliance Cure

Title: Bundling Up Against CLABSI: The Compliance Cure

Abstract : Central Line Associated Bloodstream Infections (CLABSI) result in thousands of deaths every year and are a leading cause of preventable harm in hospitalized patients. By focusing our attention on the CLABSI bundle, we have reduced CLABSIs in our hematology/oncology/transplant and cellular therapy population. A CLABSI bundle is a collection of evidence-based practices that aims to reduce the risk of CLABSIs. Bundle compliance has been our greatest hurdle over the years, but by utilizing a quality improvement approach we have been able to increase our bundle compliance. Nurses complete CLABSI audits weekly to ensure we are in compliance with the bundle and track any deficiencies. We conducted multiple PDSA cycles to drive compliance: we implemented a CLABSI nursing assistant, utilized our virtual clinical support team to text reminders to the nursing team of missed bundle elements, added bundle elements to our EMR, implemented weekly interprofessional CLABSI rounds with nursing leaders and the unit medical directors, we trialed and implemented the use of chlorhexidine (CHG) foaming soap, and we launched an oral care campaign including staff and patient/family education and reminder signage in patient rooms. We succeeded in improving bundle compliance from 77% in 2023, to an average of 86% in 2024, finishing the year with a bundle compliance of 96%. We dramatically reduced the unit CLABSI rate from 0.98 in 2023 (4 non-MBI CLABSIs) to 0.36 in 2024 (1 non-MBI CLABSI). Our 24-bed hematology/oncology/transplant unit, with one of the highest number of central line days in the hospital, surpassed over 365 days without a CLABSI and remains dedicated to exploring ways to increase bundle compliance and decrease CLABSIs.