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Achieving a Zero Central Line-Associated Bloodstream Infection Rate in 4 Critical Care Units in Lebanon

Jamous, Sabath MSN, RN; Kouatly, Iman MPH, RN; Zaatari, Rafika MSN, RN; Kurdahi Badr, Lina PhD, RN, PNP, FAAN

doi: 10.1097/NAN.0000000000000335

Every health care facility aims to achieve and maintain a zero central line-associated bloodstream infection (CLABSI) rate. Infections can be costly for institutions of any size and are often not covered by health insurance. The interventions put in place in this quality improvement project were implemented in 4 phases: (1) develop a new standard of care for central lines and give nurses full responsibility for the care and handling of these lines (including blood sampling); (2) revise policy and provide educational sessions to support nurses; (3) document compliance with the new policy; and (4) document CLABSI rates. The project took place during a 15-month period between January 1, 2016 and March 30, 2017, in 4 critical care units in a university medical center in Lebanon. The results revealed a reduction in CLABSI rates from a maximum rate of more than 17 per 1000 catheter days to zero per 1000 catheter days, which was sustained for 10 months. Nurse compliance with the new policy after 3 months ranged from 95% to 99%.

American University of Beirut Medical Center, Beirut, Lebanon (Mss Jamous, Kouatly, and Zaatari); and Azusa Pacific University, Azusa, California (Dr Badr).

Sabath Jamous, MSN, RN, is a clinical nurse specialist in the intensive care unit (ICU) at the American University of Beirut Medical Center (AUBMC) in Beirut, Lebanon. Iman Kouatly, MPH, RN, is the director of nursing at the AUBMC. Rafika Zaatari, MSN, RN, is a clinical educator in the ICU at the AUBMC. Lina Kurdahi Badr, PhD, RN, PNP, FAAN, is a professor of nursing at Azusa Pacific University in Azusa, California.

Corresponding Author: Lina Kurdahi Badr, PhD, RN, PNP, FAAN, 701 East Foothill Blvd, PO Box 7000, Azusa, CA 91702 (

The authors have no conflicts of interest to disclose.

© Copyright 2019 by Infusion Nurses Society