Using a combined nursing and medical approach to reduce the incidence of central line associated bacteraemia in a New Zealand critical care unit: A clinical audit

Objective: Research suggests a median central line associated bacteraemia rate of zero is achievable. This paper outlines the effectiveness of using a combined nursing and medical approach in reducing central line associated bacteraemia in a New Zealand critical care unit. Method: The study used a before and after audit design. Data collected between October 2007 and December 2008 prior to introducing a central line associated bacteraemia insertion bundle were compared to data collected between January 2009 and April 2011 when insertion, maintenance and high risk patient bundles were sequentially introduced. Results: Data collected between October 2007 and December 2008 identified a mean central line associated bacteraemia rate of 6.43 per 1000 catheter days (range = 0-12.30, Mdn = 6.3, SD 3.34). Introducing the insertion bundle significantly decreased the mean central line associated bacteraemia rate to 1.50 (range = 0-10.5, Mdn = 0, SD = 3.97, p = .02). Introducing a maintenance and high risk patient bundle sustained a median central line associated bacteraemia rate of zero over the following 12-month period. Conclusion: The study demonstrated a combined nursing and medical approach using central line bundles was effective in reducing the central line associated bacteraemia rate per 1000 line days and sustaining a median central line associated bacteraemia rate of zero. (C) 2012 Elsevier Ltd. All rights reserved.