Posted by: Duke Raleigh Hospital | June 7, 2012

We are passionate about patient safety, and it shows!

A Milestone in ICU Care

By Polly Padgette, Infection Preventionist and

Stephanie Johnson-Dean, RN,MSN,P-MSN, Clinical Nurse IV

Duke Raleigh’s ICU has achieved a significant safety milestone. We’ve gone two years without having a patient develop a central line associated bloodstream infection (CLABSI).

A tremendous amount of work from the entire staff helped us reach this goal. Such a milestone would never have been possible without the team approach we took.

Until very recently (March of 2010, to be exact), the medical community thought central line infections were an unfortunate, but all too common, risk in some ICU patients. Now, we know they are avoidable. And, Duke Raleigh’s ICU staff is doing all we can to prevent them.

About half of all ICU patients need a central line during their hospital stay. Usually, it’s because the patient is having trouble keeping his vital signs stable and needs more intensive monitoring or rapid fluid administration.

A central line catheter infection happens when a patient develops an infection in the bloodstream that is not related to an infection at another site. The infection may be accompanied by fever, chills or hypotension – also known as decreased blood pressure.

Patients who develop hypotension may have to go on medication to maintain their blood pressure. They’ll likely need to go on strong IV antibiotics for several days. A central line infection can increase the patient’s length of hospital stay by several days to a week.

The enhanced process, implemented in 2010, is called Central Line Insertion Bundle Compliance. The compliance process is a strict protocol our staff adheres to that involves proper dressing, line maintenance and scrubbing the hub of IV line access ports with isopropyl alcohol (70 percent) for 15 seconds prior to each use.

The new process is really a best practice developed by the North Carolina Center for Hospital Quality and Patient Safety (N.C. Quality Center), a division of the N.C. Hospital Association (NCHA), that makes central line infections much less likely. The Quality Center is a resource that allows hospitals to focus on their performance related to key quality of care and safety issues. It was established in 2004 to lead the state’s hospitals to become the safest and highest quality hospitals in the United States. Learn more at

The safety of our patients is always top-of-mind for all of us at Duke Raleigh. We’re passionate about it. The “No Excuses, No Exceptions” logo the ICU staff wears on our scrubs is an ever-present reminder to be vigilant in ensuring no patient develops a central line infection while in our care.

Find out more about how Duke Raleigh Cares about you.

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