Influence of a multifaceted intervention on central line days in intensive care units: results of a national multisite study

Am J Infect Control. 2014 Oct;42(10 Suppl):S197-202. doi: 10.1016/j.ajic.2014.06.003.


Background: Removing unnecessary central lines is a critical step in reducing risk of infection and was 1 focus of a national quality improvement collaborative. We examined if participating adult intensive care units (ICUs) reduced central line days during the project period compared with the period before implementation of the "On the CUSP: Stop BSI" program.

Methods: We used a linear regression model on a total of 9,225 ICU-quarters of data to examine the effect of the intervention on total central line days of ICU participants in the national project (2008-2012), adjusting for ICU type, hospital characteristics, project cohort, season, and accounting for repeated measures on the same unit and clustering within states using random intercepts.

Results: The regression results showed no significant change in preintervention quarters. However, significant decreases in total line days started during quarter 4 after intervention and differences were sustained through quarter 6. There were 4% fewer central line catheter days reported at the project's conclusion compared with the baseline.

Conclusions: To keep central lines from doing patients harm, clinicians must assess the need for lines and remove them as soon as clinically advisable to halt the possibility of infection via the line. Effective communication and empowering providers to identify unnecessarily extended use of central lines could accelerate the realization, someday, of eliminating central line associated bloodstream infections in ICUs.

Keywords: CLABSI bundle; Central line denominator; Central line denominator days; Central line-associated bloodstream infections; Central venous catheters; Comprehensive Unit-based Safety Program; Guidelines.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Bacteremia / epidemiology
  • Bacteremia / prevention & control*
  • Catheter-Related Infections / epidemiology*
  • Catheter-Related Infections / prevention & control*
  • Catheterization, Central Venous / adverse effects
  • Catheterization, Central Venous / methods*
  • Cross Infection / prevention & control
  • Data Collection
  • Humans
  • Infection Control / methods*
  • Intensive Care Units
  • Patient Safety
  • Quality Improvement
  • Self Report