A quality improvement program combining maximal barrier precaution compliance monitoring and daily chlorhexidine gluconate baths resulting in decreased central line bloodstream infections.

A quality improvement intervention on central line-associated bloodstream infection prevention has been ongoing at a regional medical center since February 2004, and although improvements were noted between 2004 and 2007, the incidence rate of central line-associated bloodstream infections was still of concern. A comprehensive review of all infections from October 2005 through January 2007 indicated that these rates decreased when maximal barrier precaution compliance was tracked and increased when compliance tracking stopped; therefore, an ongoing compliance-tracking program for maximal barrier precautions was instituted, and caregivers were reeducated on the importance of central-line-bundle prevention efforts. A quality improvement intervention of daily CHG baths for all ICU patients was added in April 2008. The goal of this QI intervention was to decrease the incidence rate to 0 for a sustained period, and it was successful.