BREAKING THE STREAK: STRENGTHENING CLABSI PREVENTION IN DANDENONG ICU.

Abstract

Background: Central Line Associated Bloodstream Infections (CLABSIs) are serious infections that can lead to patient morbidity and mortality, along with longer hospital stays. The Intensive Care Unit (ICU) at Monash Health Dandenong had maintained a CLABSI-free record for two years. However, between July and December 2024, five CLABSI cases were identified and reported. This prompted a thorough review of current practices, focusing on hand hygiene, aseptic technique, and adherence to Central Venous Access Device (CVAD) insertion and maintenance protocols. Action: A detailed review of existing processes was carried out. This included audits on hand hygiene, aseptic technique, dressing application and compliance with the insertion and maintenance bundle, particularly the daily chlorhexidine wash, which had low compliance at 18-28%. Education sessions were delivered to the ICU staff, focusing on proper dressing technique and line care. In addition, CVAD and chlorhexidine wash rounds were introduced to support and monitor practice at bedside. Result(s): Improvements were seen across several key areas. Hand hygiene compliance increased to 89%, aseptic technique reached full compliance (100%), and chlorhexidine wash rate rose to 85%. From January to April 2025, zero CLABSI cases were identified. These results showed that practical education, close monitoring and team engagement can lead to infection prevention improvements. Conclusion(s): Sustained CLABSI prevention in the ICU requires a holistic and consistent approach. Ongoing education is vital, especially in areas of high staff turnover such as ICU. Embedding best practices into daily workflows and maintaining staff accountability are key to long term success in preventing CLABSIs.