Using the agile implementation model to reduce central line–associated bloodstream infections

Jose Azar, Kristen Kelley, Jennifer Dunscomb, Anthony Perkins, Yun Wang, Cole Beeler, Lana Dbeibo, Douglas Webb, Larry Stevens, Mark Luektemeyer, Areeba Kara, Ryan Nagy, Craig A. Solid, Malaz Boustani

Research output: Contribution to journalArticle

3 Scopus citations


Background: Central line–associated bloodstream infections (CLABSIs) are among the most common hospital-acquired infections and can lead to increased patient morbidity and mortality rates. Implementation of practice guidelines and recommended prevention bundles has historically been suboptimal, suggesting that improvements in implementation methods could further reductions in CLABSI rates. In this article, we describe the agile implementation methodology and present details of how it was successfully used to reduce CLABSI. Methods: We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017. Results: The intervention successfully reduced the CLABSI rate from 1.76 infections per 1,000 central line days to 1.24 (rate ratio = 0.70; P =.011). We also observed reductions in the rates of Clostridium difficile and surgical site infections, whereas catheter-associated urinary tract infections remained stable. Conclusions: Using the AI model, we were able to successfully implement evidence-based practices to reduce the rate of CLABSIs at our facility.

Original languageEnglish (US)
Pages (from-to)33-37
Number of pages5
JournalAmerican Journal of Infection Control
Issue number1
StatePublished - Jan 2019


  • Central line–associated bloodstream infections
  • Implementation science
  • Quality improvement

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

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    Azar, J., Kelley, K., Dunscomb, J., Perkins, A., Wang, Y., Beeler, C., Dbeibo, L., Webb, D., Stevens, L., Luektemeyer, M., Kara, A., Nagy, R., Solid, C. A., & Boustani, M. (2019). Using the agile implementation model to reduce central line–associated bloodstream infections. American Journal of Infection Control, 47(1), 33-37.