{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:27:44Z","timestamp":1787030864826,"version":"build-2736575974"},"reference-count":47,"publisher":"AACN Publishing","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Central line [catheter]\u2013associated bloodstream infection (CLABSI) is associated with longer stays and increased cost, morbidity, and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Local Problem<\/jats:title>\n                    <jats:p>An academic cardiothoracic intensive care unit had a high CLABSI incidence (standardized infection ratio of 2.3 at baseline). The hospital\u2019s executive leadership team (chief nursing officer, chief medical officer, and chief of quality and performance improvement) directed intensive care unit leaders to reduce the standardized infection ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Interprofessional CLABSI reduction efforts were formulated using A3 methods based on the plan-do-check-act cycle. Unit leaders (nurses, physicians, advanced practice providers, and allied health professionals) met every 2 weeks for 2 years to formulate CLABSI reduction efforts. Efficacy of CLABSI reduction was evaluated with the standardized infection ratio.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Quality improvement activities included improved hand hygiene compliance, optimization of central venous catheter insertion, improved chlorhexidine dressing adherence, daily assessment of high-risk catheters for removal, use of an electronic intensive care unit bundle checklist to highlight central venous catheter duration for clinicians, and promotion of a blood culturing stewardship program with guidance on when to obtain blood samples for culture.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Interprofessional CLABSI reduction efforts reduced the standardized infection ratio from 2.3 to 0.8 over 3 years. The standardized utilization ratio, reflecting observed to expected central venous catheter days, decreased from 1.0 to 0.89.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Interprofessional CLABSI reduction efforts can be effective in a cardiac surgical intensive care unit and improve patient safety. Keys to success include teamwork, accountability, acceptance from intensive care unit staff, and support from hospital executive leaders.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2025723","type":"journal-article","created":{"date-parts":[[2025,5,31]],"date-time":"2025-05-31T20:03:29Z","timestamp":1748721809000},"page":"11-22","source":"Crossref","is-referenced-by-count":7,"title":["Interprofessional Approach to Reducing Central Line\u2013Associated Bloodstream Infections in a Cardiac Surgical Intensive Care Unit"],"prefix":"10.4037","volume":"45","author":[{"given":"Michael","family":"Mazzeffi","sequence":"first","affiliation":[{"name":"Michael Mazzeffi is an anesthesiologist and critical care physician, Department of Anesthesiology, University of Virginia School of Medicine, Charlottesville, Virginia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcia P.","family":"White","sequence":"additional","affiliation":[{"name":"Marcia P. White is a director of nursing, inpatient heart and vascular, University of Virginia Health, Charlottesville."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Wade","sequence":"additional","affiliation":[{"name":"Ashley Wade is the nurse manager for the thoracic and cardiovascular intensive care unit (ICU), University of Virginia Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"Jordan","sequence":"additional","affiliation":[{"name":"Jacob Jordan is an assistant nurse manager for the thoracic and cardiovascular intensive care unit, University of Virginia Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akram","family":"Zaaqoq","sequence":"additional","affiliation":[{"name":"Akram Zaaqoq is medical director of the thoracic and cardiovascular ICU, Department of Anesthesiology, University of Virginia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily","family":"Schneiderman","sequence":"additional","affiliation":[{"name":"Emily Schneiderman is the lead advanced practice provider for the thoracic and cardiovascular ICU, Department of Anesthesiology, University of Virginia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tiffany","family":"Phillips","sequence":"additional","affiliation":[{"name":"Tiffany Phillips is an assistant nurse manager for the thoracic and cardiovascular ICU, University of Virginia Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claire","family":"Davis","sequence":"additional","affiliation":[{"name":"Claire Davis is a critical care physician, Department of Chest and Critical Care Medicine, Scripps Green Hospital, Scripps Clinic Medical Group, San Diego, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jolian","family":"Dahl","sequence":"additional","affiliation":[{"name":"Jolian Dahl is a cardiothoracic surgeon, Department of Cardiothoracic Surgery, Kaiser Permanente, Los Angeles, California."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"McNeil","sequence":"additional","affiliation":[{"name":"John McNeil is division chief for cardiothoracic anesthesiology, Department of Anesthesiology, University of Virginia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Singh","sequence":"additional","affiliation":[{"name":"Karen Singh is a cardiothoracic anesthesiologist, Department of Anesthesiology, University of Virginia School of Medicine."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joan","family":"Buckner","sequence":"additional","affiliation":[{"name":"Joan Buckner is a hospital epidemiologist, University of Virginia Health."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Costi D.","family":"Sifri","sequence":"additional","affiliation":[{"name":"Costi D. 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