Table 2. Resources potentially required to implement a catheter care bundle.
| Activity | Resources | |
| Unit | Frequency | |
| Catheter care bundle components | ||
| Components | ||
| Appropriate hand hygiene | 30 seconds | per catheter |
| Maximal sterile barrier precautions at insertion | ||
| mask, gloves, gown, cap, large drape | 1 set | per catheter |
| preparation of precautions | 20 minutes | per catheter |
| Chlorhexidine skin preparation | 7 day supply | per catheter |
| Subclavian vein placement preferred | no additional activity | |
| Prompt removal of catheters | no additional activity | |
| Central line supply care | ||
| Stocking of cart | no data | every 4 hours |
| Use of cart | time saving | per catheter |
| Education & monitoring activities | ||
| Education | ||
| Nurse lectures | 40 minutes | 16 lectures |
| Physician lectures | 40 minutes | 5 lectures |
| Web-based physician training module | no data on duration or attendees | no data on repetition |
| Nurse orientation module | no data on duration or attendees | no data on repetition |
| Posters & factsheets | no data on numbers | no data numbers |
| Checklist for insertion | ||
| Training on use | no data on duration or attendees | no data on repetition |
| Use of checklist | 2 minutes | per catheter |
| Feedback on performance | no data on resources | no data on repetition |
| Collation & feedback of infection rates | no data on resources | no data on repetition |
| Mentoring & leadership activities | ||
| Keystone project support* | ||
| Conference calls from Keystone | no data on duration or attendees | 2 per month |
| Conference calls from Hopkins | no data on duration or attendees | 1 per month |
| Statewide meetings | no data on duration or attendees | 2 per year |
| Participant website | no data on resources | no data on updates |
| Bimonthly e-newsletter | no data on resources | 2 per month |
| Institution visits | no data on resources | no data on repetition |
| Key personnel (average four) per hospital | ||
| Physician leader | 4–8 hours | per week |
| Nurse leader | 4–8 hours | per week |
| Senior executive | 4–8 hours | per week |
| Staff nurse/infection control practitioner/pharmacist | 4–8 hours | per week |
| Program activities | ||
| Education session & safety survey | 40 minutes, all staff | once |
| Senior executive meetings | no data on duration or attendees | 1 per month |
| Daily goals sheet for communication | no data on resources | 3 per day |
| Nurse pre-discharge medication review | no data on resources | per admission |
| Web-based error reporting system | no data on resources | no data on maintenance |
*Keystone funded to $15 million to undertake multiple projects not just a catheter care bundle.
Resources were identified based on the following publications:
Pronovost PJ, Berenholtz S, Dorman T, Lipsett PA, Simmonds T, Haraden C: Improving communication in the ICU using daily goals. J Crit Care 2003, 18:71–75.
Pronovost PJ, Weast B, Bishop K, Paine L, Griffith R, Rosenstein B, Kidwell RP, Haller KB, Davis R: Senior executive adopt-a-work unit: a model for safety improvement. Jt Comm J Qual Patient Saf 2004, 30:59–68.
Pronovost PJ, Goeschel C: Improving ICU care: it takes a team. Healthc Exec 2005, 20:15–22.
Pronovost PJ, Weast B, Rosenstein B, Sexton B, Holzmueller CG, Paine L, Davis R, Rubin HR: Implementing and validating a comprehensive unit-based safety program. Journal of Patient Safety 2005, 1:33–40.
Pronovost PJ, Needham DM, Berenholtz S, Sinopoli D, Chu H, Cosgrove SE, Sexton B, Hyzy R, Welsh R, Roth G, Bander J, Kepros J, Goeschel C: An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006, 355:2725–2732.
Berenholtz SM, Pronovost PJ, Lipsett PA, Hobson D, Earsing K, Farley JE, Milanovich S, Garrett-Mayer E, Winters BD, Rubin HR, Dorman T, Perl TM: Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med 2004, 32:2014–2020.