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CLABSI Toolkit - Chapter 4

CLABSI Patient Safety Initiatives: Factors Contributing to Improvement

This chapter introduces strategies associated with implementing successful central line-associated bloodstream infection (CLABSI) prevention programs.

Key points include the following:

  • Clinical practice guidelines (CPGs) — guidelines developed by experts who evaluate the state of the evidence and make practice recommendations for busy clinicians to review and incorporate into actual practice — are valuable resources only if they result in an actual improvement in practice patterns.

  • As a first step, consider using a systematic and multidisciplinary approach to identify and prioritize CPGs and remove the local barriers that can diminish CPG adherence.

  • Among the most important internal and external factors that can affect the success of any improvement initiative designed to reduce or eliminate health care-associated infections, including CLABSIs, are leadership, culture of safety, multidisciplinary teams and teamwork, accountability of health care personnel, empowerment, resource availability, data collection and feedback of CLABSI rates, policies and procedures, and involvement of patients and families.

  • A collaborative approach to improving CLABSI rates has emerged as a means to facilitate the use of infection prevention practices, even in resource-limited settings.

Related Tools


Team Strategies and Tools to Enhance Performance and Patient (TeamSTEPPS) toolkit 

Accountability  of Health Care Personnel in Preventing CLABSIs 

CUSP toolkit

Note: See Chapter 5 for detailed information regarding Surveillance Systems, Measures, and Measurement Approaches.

Note: Applicable Policies and Procedures are included under corresponding chapters within the toolkit. Organizations should review their policies and procedures, as well as actual practices, against recommended best practices. On an ongoing basis, policies should be reviewed and updated as new information or technology becomes available.

  • Lessons from the Keystone ICU Project

  • For Further Reference

    • Apisarnthanarak A, Greene T, Kennedy EH, Khawcharoenporn T, Krein S, Saint S. National survey of practices to prevent healthcare associated infections in Thailand: The role of safety culture and collaboratives. Infect Control Hosp Epidemiol. 2012 Jul; 33(7):711-717.