Hospital acquired infections, also known as healthcare-associated infections (HAIs), are a significant issue that impacts patient outcomes and increases healthcare costs. Implementing quality improvement projects focused on evidence-based practices to reduce HAIs has been shown to be an effective way for hospitals and healthcare workers to enhance patient safety. Here are some examples of successful capstone projects that have made a meaningful impact in reducing various types of hospital acquired infections:

One notable project took place at an academic medical center and focused on reducing central line-associated bloodstream infections (CLABSI) in the intensive care unit (ICU). CLABSIs occur when bacteria or viruses enter the bloodstream through a central line catheter. This project used the Model for Improvement framework to test changes. Interventions implemented included adopting a maximal sterile barrier during central line insertion, using chlorhexidine for skin antisepsis, and focusing on prompt removal of unnecessary lines. Compliance with best practices was tracked and deficiencies were addressed. After 12 months, the medical ICU saw a 65% reduction in CLABSI rates from a baseline of 3.7 infections per 1,000 line days to 1.3 infections. This reduction equated to 17 avoided infections and an estimated cost savings of $514,000 for the hospital.

Another successful capstone quality improvement project centered around reducing catheter-associated urinary tract infections (CAUTIs) in a surgical ICU. CAUTIs develop when bacteria enter the urinary tract through a catheter. The project team established evidence-based practices for catheter insertion and maintenance, including use of aseptic technique and sterile equipment during insertion, securing catheters properly after insertion, and only using catheters when necessary as indicated by daily reviews. Educational programming was provided to nurses. Visual aids served as daily reminders. Within 6 months of implementing the changes, monthly CAUTI rates dropped from a baseline of 2.6 per 1,000 catheter days to zero infections, representing a 100% reduction. An estimated 20 avoided infections resulted in cost savings of $400,000 for the hospital.

A capstone project at a community hospital targeted reducing ventilator-associated pneumonia (VAP) in its medical ICU. VAP occurs when bacteria enter the lungs through an endotracheal breathing tube in patients on mechanical ventilation. The core project team developed a multidisciplinary VAP bundle checklist and instituted “VAP champions” – nurses trained to serve as expert resources on VAP prevention. Education focused on maintaining the head of the bed at 30 degrees or higher, oral care with chlorhexidine, and ensuring peptic ulcer disease prophylaxis. Process measures showed near perfect compliance with the bundle elements. After 6 months, the VAP rate dropped from a baseline of 3.3 per 1,000 ventilator days to 1.7, representing almost a 50% reduction. An estimated 10 VAPs were prevented, saving the hospital approximately $300,000.

Another successful quality improvement capstone took place at a large tertiary care hospital and focused on reducing surgical site infections (SSIs) specifically after coronary artery bypass graft (CABG) surgery. SSIs occur when bacteria enter through an incision made during surgery. Best practices targeted in the project included pre-operative chlorhexidine showers or wipes for patients, appropriate antibiotic prophylaxis timing and selection, intra-operative normothermia maintenance, glucose control, wound protection, and smoking cessation support. educational in-services and visual prompts reinforced the changes. Over 18 months, compliance with all SSI prevention practices improved significantly from a baseline average of 65% to 95%. Simultaneously, the CABG SSI rate declined by 50%, from 2.5% of patients to 1.2%. This reduction meant 19 fewer infections annually and an estimated cost avoidance exceeding $500,000.

As demonstrated through these illustrative capstone quality improvement projects, multi-pronged, evidence-based approaches focused on consistent adherence to best practices can meaningfully reduce hospital acquired infection rates. Sustained reductions in CLABSI, CAUTI, VAP, and SSIs each lead to improved patient outcomes and substantial cost savings. A culture of safety, staff education, visual reminders, consistent leadership support, and multidisciplinary involvement all contributed to success. With applied efforts to optimize evidence-based care, hospitals can enhance quality and safety for patients through effective measures targeting the reduction of preventable HAIs.