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

SummaryObjectiveResearch 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.MethodThe 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.ResultsData 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.ConclusionThe 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.