Important Steps in the Quality Improvement Process: Central Line Insertion

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Recommended: Prevention of central line infections

The book outlines the important steps that make up the Quality Improvement (QI) processes. First you must identify the needs that are most important. Second a multidisciplinary team must be put together to review the needs that have been identified. Third data must be collected to assess the current situation being evaluated. The fourth step should be to create goals and quality indicators that can be assessed and evaluated. The fifth step is where you develop and place into practice the plan to achieve the desired outcome/ goals. Lastly data must be collected to assess the effectiveness in the change of practice, and to see of all goals have been met.

The QI project that will be described in this analysis pertains to catheter related blood stream infections (CR-BSI). CR-BSI and the ability in which they can be prevented is a common focus in the healthcare industry. The Center for Disease Control (CDC) has reported that 5 CR-BSI per 1000 catheter days is the current rate of infection. This translates into 80,000 patients every year will acquire a CR-BSI. This infection can be introduced at the time of insertion, or by the way in which it is used and cared for. This report of 80,000 patients is only limited to studies based on patients in various Intensive Care Units. Current infection rates for medical surgical units, skilled nursing centers, home health, and ambulatory care patients does not exist. An estimate by many researchers would place the annual number of CR-BSI at 250,000 cases. The estimated deaths caused by CR-BSI at around 12-25% of the total infections. In addition to increased mortality the approximate cost per infection is $ 25, 000. (Posa, Harrison, & Vollman, 2006, p. 446) These numbers leave large room for impro...

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..., D. L., & Saint, S. (2004). Using maximal sterile barriers to prevent central venous catheter-related infection. American Jouranl of Infection Control, 32, 142-146.

Orto, V., & Greene, L. R. (2006). Beyond the ICU: nursing’s role in decreasing central venous CR-BSIs. Retrieved June 10, 2010, from www.nursingmangement.com

Posa, P. J., Harrison, D., & Vollman, K. M. (2006). Elimination of central line-associated bloodstream infections. Advanced Critical care, 17, 446-454.

Shuman, E. K., Washer, L. L., Arndt, J. L., Zalewski, C. A., Napolitano, L. M., & Hyzy, R. C. et al. (2010). Analysis of central line-associated bloodstream infections in the intensive care unit after implementation of central line bundles. Infection Control and Hospital Epidemiology, 31, 551-553.

Yoder-Wise, P. S. (2007). Leading and managing in nursing (4th ed.). St Louis, MO: Mosby Elsevier.

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