Checklists in critical care

The first significant example of a collaborative, checklist-based approach to improving patient safety was tested across 108 ICUs as part of the National Nosocomial Infections Surveillance System in the USA to reduce central venous catheter-related bloodstream infections.

Related paper: An Intervention to Decrease Catheter-Related Bloodstream Infections in the ICU

This included 5 simple steps:

• Appropriate hand hygiene
• Use of chlorhexidine for skin preparation
• Use of full-barrier precautions
• Subclavian vein placement as the preferred site
• Removing unnecessary CVCs

The intervention reduced the incident rate ratios of catheter related infections by 38% by 3 months post-implementation and sustained this to a 66% reduction by 16-18 months post-implementation.

This demonstrated the power of communities of colleagues caring for complex patient groups to improve patient outcomes by improving communication and harmonising practice