Central Line Associated Bacteraemia in Intensive Care Units
Central line insertion is an invasive procedure frequently performed in the intensive care unit (ICU). Patients in ICUs are at high risk of health care associated infections, including central line associated blood stream infections (CLAB), many of which are considered preventable
The Central Line Associated Bacteraemia in Intensive Care Units project (CLAB-ICU) is a NSW Statewide initiative that aims to improve patient outcomes, by reducing CLAB in ICUs. It advocates a standard sterile insertion practice. The project is overseen by the Intensive Care Co-ordination and MonitoringUnit (ICCMU) and the Clinical Excellence Commission (CEC), with the co-operation of the NSW Ministry of Health's Quality and Safety Branch. All level 5 and 6 ICUs are participating.
CLAB ICU is the first collaborative between the ICCMU and CEC providing an opportunity for clinicians to drive change at the coal face.
The project uses a top-down bottom-up collaborative methodology, based on a quality improvement program successfully implemented in the United States. It demonstrates that compliance with maximal sterile barrier precautions can result in a reduction in CLAB. The project promotes appropriate hand hygiene,skin preparation and maximal sterile barrier precautions during insertion.
Intensive care specialists have developed practice guidelines and an insertion checklist to support sterile insertion of central lines.
The project is making significant contributions in developing a framework for CLAB reduction in NSW, creating resources and networks and standardising care. Participating units can access the following resources to support local practice:
- Insertion checklist: record of procedure that encourages compliance with policy
- An education and training framework to improve transferability of skill, recognition of prior competence between units and improve patient safety and care
- E-learning tools to support standard education and training
- Regular compliance reports to support clinical governance and celebrate excellence in care
- A standardised central line procedure pack
- Posters to maintain awareness of current information.
- 6 key elements for safe insertion of central lines - PDF ~1238kb
- ICU CLAB definition and reporting - PDF ~148kb
- ICU CLAB detection and reporting flowchart - PDF ~164kb
- Central Line Insertion Online Training - To view ~ opens new window
- Insertion checklist - PDF ~896kb
- Tally tool for collection of patient line-days and record of ICU CLAB events - XLS ~226kb
For more information read the ICU CLAB data collection FAQ - PDF ~197kb | TXT ~8kb
- Education and Training Framework - PDF ~288kb | TXT ~17kb
- CLAB ICU Final Report - PDF ~620kb
- CLAB ICU Project Scope - PDF ~157kb | TXT ~43kb
- Nursing Care of Central Venous Catheters in Adult Intensive Care: NSW Health Statewide Guidelines for Intensive Care - PDF ~1837kb | TXT ~757kb
- Healthcare Associated Infection: Clinical Indicator Manual Version 2.0 - PDF ~1.79mb | TXT ~76kb