Reducing the Rate of Central Line Associated Blood Stream Infections in the ICUs
Care Process & Redesign
National Healthcare Group Quality Improvement
National Healthcare Group
24 December 2025
To reduce all ICUs Central Line Associated Bloodstream Infection (CLABSI) rate by 50% from 1.66 to 0.83 per 1000 central. The interventions show promise for reducing CLABSI rates in ICUs, with a significant reduction observed in the pilot site and plans to.
Year Submitted: 2025
Published Date: 24 December 2025
Tags: Care Process ＆ Redesign, Workflow Redesign, Cost Saving, Quality Improvement, Value Based Care, Safe Care, Productivity
About this Content
Aims
To reduce all ICUs Central Line Associated Bloodstream Infection (CLABSI) rate by 50% from 1.66 to 0.83 per 1000 central line days from Year 2020 to Year 2024.
Background
Central Line Associated Bloodstream Infection (CLABSI) is associated with increased morbidity, hospital length of stay, and healthcare costs. In the TTSH Intensive Care Units (ICUs), implementation of full barrier precautions and a line maintenance bundle since Year 2016 and 2017 has helped to bring down CLABSI rates in the hospital. However, the effect of these interventions plateaued, indicating other factors driving the CLABSI rate.
Methods
A multidisciplinary approach was taken to contain CLABSI rates. Interventions were implemented in one ICU as the pilot site in Year 2021, and if found effective, were spread to other ICUs. Root causes were identified, and specific interventions were rolled out at the pilot site (Ward 6B MICU) over different time periods.
Results
A significant reduction in CLABSI infections was observed over the course of the project. The annual CLABSI rate decreased from 1.82 in 2020 to 0.70 in 2023.
Conclusion
The interventions show promise for reducing CLABSI rates in ICUs, with a significant reduction observed in the pilot site and plans to spread successful interventions to other sites.
Lessons Learnt
Staff engagement and buy-in were crucial for the success of the interventions. Regular announcements of audit results and CLABSI rates at nursing roll calls and department meetings increased staff engagement.
Keywords
CLABSI, Infection Control, ICU, Cost Saving, Quality Improvement
Innovators' Details
Innovators' Details
Healthcare Cluster(s) | National Healthcare Group |
Organization(s) Involved | Tan Tock Seng Hospital |
Platform(s) | National Healthcare Group Quality Improvement |
Healthcare Professional Group(s) | Nursing |
Applicable Specialty or Discipline | Infectious Diseases |
Project Lead(s) | Sennen Lew |
Project Member(s) | Nur Liyana Binte Ismail |
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Group Quality - nhggroup.QRM@nhghealth.com.sg