Mary E. Seddon, M.B., Ch.B., M.P.H., Catherine J. Hocking, Pat Mead, and Catherine Simpson
M. E. Seddon, C. J. Hocking, P. Mead et al., "Aiming for Zero: Decreasing Central Line Associated Bacteraemia in the Intensive Care Unit," New Zealand Medical Journal, July 29, 2011 124(1339):9–21.
Central line–associated bloodstream infections, also know as central line–associated bacteraemia (CLAB), are one of the most common and lethal complications of hospital care. They can occur when a central venous catheter is not inserted or maintained properly. Research shows, however, that such infections can be reduced or avoided altogether through appropriate preventive procedures.
This study, by former Commonwealth Fund Harkness Fellow Mary Seddon and colleagues, describes the effort to eliminate CLAB among critical-care patients in one New Zealand institution, Middlemore Hospital. The intervention, begun in December 2008, included the following components:
The number of CLAB at Middlemore fell from 14 in 2008 to four in 2009, and then to just one in the first half of 2010. Conservatively estimated cost savings were approximately NZ$200,000 (US$152,200) in 2009 and NZ$260,000 (US$197,900) in 2010.
The authors conclude that it is possible to significantly decrease CLAB among critical-care patients using evidence-based care protocols. The effort reduced patient morbidity and mortality, while also reducing spending.