| Sumario: | Significance & Background: Central line-associated bloodstream infections (CLABSIs) are a concern in hematopoietic cell transplant (HCT) patients due to their immunocompromised status and frequent, prolonged use of central venous catheters. These patients undergo intensive chemotherapy, neutropenia, and face treatment complications, all of which heighten their vulnerability to infection. CLABSIs not only increase morbidity and mortality but also contribute to extended hospital stays and increase hospital cost. Research suggests that specific hygiene interventions in addition to quality nurse education in relation to infection prevention can help reduce CLABSI rates among immunocompromised patient populations (Foka et. al, 2021; Jarding & Makic, 2021). Purpose: The infection prevention team and inpatient nursing staff identified a need to reduce CLABSIs in hematopoietic cell transplant patients. The "Journey to Zero" CLABSI initiative became a multi-faceted effort to re-emphasize existing practices, introduced new strategies, and deliver targeted education through various nursing channels. Interventions: Nursing staff received re-education on key infection prevention protocols, including hand hygiene, patient showers, and CHG baths. New standardized practices were introduced, such as proper blood culture collection and scrubbing injector caps with alcohol pads between aseptic cap usage. Nurses participated in hands-on in-services to reinforce sterile dressing change techniques, and a dedicated central line dressing change team was trialed. Education was delivered through bulletin boards, audits, and interactive activities, all aligned with the "Journey to Zero" initiative. Results: Before the Journey to Zero initiative began in July 2024, the hematopoietic cell transplant unit reported seven CLABSIs between July 2023 and July 2024. Since the initiative's launch, the number of CLABSIs decreased slightly to four cases from July 2024 to July 2025. Discussion: The HCT inpatient unit has successfully maintained the hygiene practices introduced during the Journey to Zero initiative and results continue to be evaluated. However, some strategies, such as the blood culture collection guideline were adjusted to better align with hospital-wide standards. Additionally, the dressing change team pilot, which ran for six months, was discontinued--not due to a lack of impact on CLABSI rates, but because staffing challenges made it unsustainable.
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