RT Journal Article SR Electronic T1 Elimination of central-venous-catheter-related bloodstream infections from the intensive care unit JF BMJ Quality & Safety JO BMJ Qual Saf FD BMJ Publishing Group Ltd SP 174 OP 180 DO 10.1136/bmjqs.2009.037200 VO 20 IS 2 A1 Andrew G Longmate A1 Kirsteen S Ellis A1 Louise Boyle A1 Shaun Maher A1 Chris J S Cairns A1 Suzanne M Lloyd A1 Colin Lang YR 2011 UL http://qualitysafety.bmj.com/content/20/2/174.abstract AB Introduction Central-venous-catheter (CVC)-related bloodstream infection (CRBSI) is a complication of intensive care stay which can have important adverse consequences for both patient and institution. There are a number of evidence-based interventions that reduce CRBSI, but it is recognised that consistently applying the best evidence every time is a challenge.Methods The authors set out to reduce CRBSI and introduced interventions in our intensive care unit (ICU) over a 4-year period using a quality improvement approach. In a setting supportive to change and improvement, the authors established infection surveillance and introduced bundles of care processes relating to insertion and maintenance of CVCs. The changes were supported by educational interventions. The authors measured care processes and outcomes, and used statistical process control charts to illustrate changes. The final 18 months of the work was performed in the context of a national safety improvement programme (The Scottish Patient Safety Programme).Results Following interventions, the annual CRBSI rate fell from 3.4 to 0/1000 patient days with zero episodes during the final 19 months of the study.Conclusions The authors describe a significant reduction in CRBSI for the first time in a UK ICU. The authors summarised and simplified what to do, measured and provided feedback on outcomes, and improved expectations of performance standards for care processes. The authors believe that these approaches are worthy of serious consideration elsewhere.