The first significant example of a collaborative, checklist-based approach to improving patient safety was tested across 108 ICUs as part of the National Nosocomial Infections Surveillance System in the USA to reduce central venous catheter-related bloodstream infections.
Related paper: An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU
This included 5 simple steps:
- Appropriate hand hygiene
- Use of chlorhexidine for skin preparation
- Use of full-barrier precautions
- Subclavian vein placement as the preferred site
- Removing unnecessary CVCs
The intervention reduced the incident rate ratios of catheter related infections by 38% by 3 months post-implementation and sustained this to a 66% reduction by 16-18 months post-implementation.
This demonstrated the power of communities of colleagues caring for complex patient groups to improve patient outcomes by improving communication and harmonising practice.