Getting to zero central line associated bloodstream infections: a multidisciplinary quality improvement project in a burn population

Alexander Kurjatko; Robertino Simpson; Sarah Wellsandt; Jia Ern Ong; Robert Bertellotti; Brooke Dwars; Lucy Wibbenmeyer

doi:10.1016/j.burns.2025.107706

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Getting to zero central line associated bloodstream infections: a multidisciplinary quality improvement project in a burn population

Journal article

Peer reviewed

Getting to zero central line associated bloodstream infections: a multidisciplinary quality improvement project in a burn population

Alexander Kurjatko, Robertino Simpson, Sarah Wellsandt, Jia Ern Ong, Robert Bertellotti, Brooke Dwars and Lucy Wibbenmeyer

Burns, Vol.51(9), 107706

12/2025

DOI: 10.1016/j.burns.2025.107706

PMID: 41109166

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Abstract

Background Thermally injured patients are at higher risk for central line associated bloodstream infections (CLABSIs) than other critically ill patients. Despite this, the expectation is zero CLABSI for the burn population. Scarce literature exists regarding CLABSI prevention in burn injured patients, with literature indicating divergent recommendations for the thermally injured compared to other critically ill cohorts. We undertook a quality improvement project (QI) to decrease our CLABSI rates. Methods All burn patients 15 years and older were admitted to our burn unit from 2017-2022 with a central line placed during their stay included. The burn team instituted a multidisciplinary CLABSI intervention in three phases that focused on education, line necessity discussions, and protocoled replacement of central lines. Chi-square, Fisher exact and Mann-Whitney tests were used to compare variables between those with and without CLABSIs. Eight patients developed nine CLABSIs. Results The study phases were similar, in regard to clinically assessed variables. Patients with CLABSIs had larger burns, more central lines, more ventilator days, and longer lengths of stay. The CLABSI rate was 3.5% during the control period. After initially increasing, the rate decreased to 1.3% in phase 3 with no CLABSIs in the subsequent year (2023). Only line days were independently related to CLABSI, with an increase of 6.7% for each day the central line was in place. Conclusions This multidisciplinary project was associated with a decrease in the CLABSI rates in burn patients reaching zero CLABSIs the following year. As this practice is counter to national central line management recommendations, it is imperative that multicenter prospective studies systematically evaluate the practice of routine line changes as part of CLABSI prevention in burn patients.

Burn injury

Burns

CLABSI

Central line infections

Central line bundles

Quality Improvement

Details

Title: Subtitle: Getting to zero central line associated bloodstream infections: a multidisciplinary quality improvement project in a burn population
Creators: Alexander Kurjatko - University of Iowa
Robertino Simpson - University of Iowa
Sarah Wellsandt - University of Iowa
Jia Ern Ong - University of Iowa
Robert Bertellotti - University of Iowa
Brooke Dwars - University of Iowa
Lucy Wibbenmeyer - University of Iowa
Resource Type: Journal article
Publication Details: Burns, Vol.51(9), 107706
DOI: 10.1016/j.burns.2025.107706
PMID: 41109166
NLM abbreviation: Burns
ISSN: 0305-4179
eISSN: 1879-1409
Publisher: ELSEVIER SCI LTD
Grant note: Vericel CorporationSkingenix
The authors declare the following financial interests/personal re-lationships which may be considered as potential competing interests: Lucy wibbbenmeyer reports was provided by The University of Iowa Roy J and Lucille A Carver College of Medicine. Lucy Wibbenmeyer reports a relationship with PolyNovo North America LLC that includes: consulting or advisory, funding grants, and travel reimbursement. Lucy Wibben-meyer reports a relationship with Vericel Corporation that includes: consulting or advisory, funding grants, speaking and lecture fees, and travel reimbursement. Lucy Wibbenmeyer reports a relationship with Spectral MD Holdings Ltd that includes: funding grants. Lucy Wibben-meyer reports a relationship with Skingenix that includes: funding grants. Alexander Kurjatko reports a relationship with Vericel Corpo-ration that includes: consulting or advisory. Alexander Kurjatko reports a relationship with Direct Biologics LLC that includes: funding grants. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper
Language: English
Electronic publication date: 09/17/2025
Date published: 12/2025
Academic Unit: Surgery; Injury Prevention Research Center
Record Identifier: 9984966541502771

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