Secondary Logo

Journal Logo

Institutional members access full text with Ovid®

Effect of a Systemwide Approach to a Reduction in Central Line–Associated Bloodstream Infections

Ferrari, Sarah DNP, CNS, CCIM, CPHON; Taylor, Kristine DNP, PCNS-BC, CENP

doi: 10.1097/NCQ.0000000000000410
Original Article: PDF Only

Background: Unit-based initiatives were deployed independently creating silos in practice variability across the system with little impact on reduction of central line–associated bloodstream infections (CLABSI).

Problem: The goal was to decrease CLABSI systemwide by establishing standardized evidence-based practice (EBP) procedures to advance nursing practice.

Approach: A new innovative method, the Ferrari Method for Practice Standardization, enhanced the quality infrastructure by merging EBP and lean methodology to translate nursing innovations into practice. Leveraging a culture of shared decision making to support autonomy, as well as collaborating interprofessionally, allowed the organization to standardize and sustain CLABSI prevention.

Outcomes: The Ferrari Method for Practice Standardization successfully reduced CLABSI rates by 48% over a 1-year improvement cycle. Eight standardized EBP clinical procedures were developed and implemented across the organization.

Conclusion: The implementation of the Ferrari Method for Practice Standardization swiftly moves new knowledge into clinical practice to improve outcomes. Using standardized improvement methodology, it eases the interprofessional approval processes, maximizes autonomy, and focuses on quality care.

Center for Professional Excellence and Inquiry, Stanford Children's Health, Palo Alto, California.

Correspondence: Sarah Ferrari, DNP, CNS, CCIM, CPHON, Center for Professional Excellence and Inquiry, Stanford Children's Health, 725 Welch Rd, Palo Alto, CA 94304 (

The authors thank Edward Anthony for his knowledge and encouragement in learning the lean methodology used in this quality improvement project.

The authors declare no conflicts of interest.

Supplemental digital content is available for this article. Direct URL citation appears in the printed text and is provided in the HTML and PDF versions of this article on the journal's Web site (

Accepted for publication: March 25, 2019

Published ahead of print: May 27, 2019

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved