SHM Converge Scientific Abstract ePoster Gallery-Pull the Line on Clabsi: Remove to Improve

Pdf Summary

This poster describes a quality improvement project aimed at reducing central line–associated bloodstream infections (CLABSIs) by improving central venous access device (CVAD) removal practices. The team noted that CLABSIs are preventable but linked to increased mortality, readmissions, and length of stay. Local data showed that 65% of CLABSIs occurred within 20 line-days, motivating a structured removal protocol.<br /><br />In Phase 1 of a multiphase Plan-Do-Study-Act initiative, a multidisciplinary team on two medicine units reviewed CVAD necessity daily over 30 days for 24 patients. Nursing and pharmacy staff assessed whether each line was still indicated, communicated recommendations to the primary team through EMR chat, and involved a resident liaison for onsite coordination. The vascular access team provided support when peripheral IV options needed evaluation before removal. Data collected included device type, dwell time, removal timing, and reinsertion events.<br /><br />Results showed that 75% of CVADs were removed within 24 hours of review. No CLABSIs occurred, and no patients required CVAD reinsertion. The project demonstrated that structured, multidisciplinary review can reduce central line utilization without increasing risk or creating access issues.<br /><br />The conclusion was that a CVAD removal protocol is an effective stewardship strategy that safely decreases unnecessary central line exposure, supports patient safety, and may lower infection-related costs. The authors recommend broader implementation across units.

Asset Subtitle

Unnati Vishwakarma

Meta Tag

Author List Casey Keefer, Harvir S. Gambhir, Mark J.E. Bovard, Unnati Vishwakarma

Category Innovations

Concept Central Venous Access Device Removal Protocol

Concept Catheter-Associated Bloodstream Infection

Concept Central Venous Access Device Necessity

Concept Central Line Utilization

Concept Daily Device Necessity Assessment

Distinguished Non-Finalist

Presenter Organization Upstate Medical University

Presenting Author Unnati Vishwakarma

Track Quality Improvement

Keywords

CLABSI

central line-associated bloodstream infection

CVAD removal

quality improvement

PDSA

multidisciplinary team

central venous access device

patient safety

infection prevention

stewardship

Central Venous Access Device Removal Protocol

Catheter-Associated Bloodstream Infection

Central Venous Access Device Necessity

Central Line Utilization

Daily Device Necessity Assessment