Improving central venous catheter insertion documentation to facilitate electronic surveillance of bundle compliance.

We developed an electronic surveillance system and modified electronic medical record and documentation practices to allow automated tracking of the central line bundle documentation with the insertion of central venous catheters. Despite significant improvements in documented use of the central line bundle in >80% of insertions, our central line-associated bloodstream infection rate remained unchanged, suggesting the need to further improve compliance toward a goal of 100% of central line insertions, as well as training and education on proper line maintenance for catheters that are medically required for prolonged periods.