CLABSI bundle containing chlorhexidine-impregnated dressings
Abstract:
Background: Central line [catheter]-associated bloodstream infections (CLABSIs) represent a significant mortality risk.
Local problem: Due to a significant increase in CLABSI rate, a new CLABSI prevention bundle strategy was evaluated to determine whether it changed the CLABSI rate.
Methods: A before and after quality improvement project was performed in an 18-bed intensive care unit from March 1, 2021, to March 1, 2025. A CLABSI prevention bundle was implemented; CLABSI rates were compared for 1 year before to 3 years after intervention implementation. Additionally, clinician satisfaction surveys were collected.
Interventions: The implemented bundle consisted of (1) replacement of disposable stethoscopes with touch-free, aseptic stethoscope diaphragm cover dispensers (DiskCover System, AseptiScope, Inc) in each intensive care unit room, and (2) requiring a chlorhexidine-impregnated dressing for all central catheters, with standardization and reeducation of bedside staff on central catheter dressing changes.
Results: Of 5226 intensive care unit patients, the mean CLABSI rate was 4.42 (95% CI, 2.93-5.91) infections per 1000 patient central catheter days during the year before implementation, which decreased to 0.70 (95% CI, -1.21 to 2.61) in the 3 years after implementation. Clinicians reported the new strategy was easy to use and superior to disposable stethoscopes.
Conclusion: A CLABSI bundle that included touch-free, aseptic stethoscope hygiene barriers and chlorhexidine-impregnated dressings was highly effective at decreasing the CLABSI rate.
Reference:
Ragsdale N, Simpson W, Peacock WF. Using Stethoscope Hygiene Barriers to Reduce Central Catheter-Associated Bloodstream Infection Rates. Crit Care Nurse. 2026 Oct 1;46(5):61-66. doi: 10.4037/ccn2026637. PMID: 42815913.