Background: Aster Medcity is a 400-bed tertiary-care hospital in India. Over the years, the CLABSI rates have been within the INICC benchmarks but much above the CDC benchmarks. Is it possible to achieve the CDC/NHSN benchmarks without using engineered vascular access devices? How can we implement the available evidence in using feedback as an effective way to improve practices? Methods: In this prospective interventional trial, we compared the CLABSI rates at baseline over the previous 6 months (January 2019 to June 2019) with the CLABSI rates over the following 3 months (July –September 2019) with introduction of a new feedback structure. This feedback was delivered in the following ways. (1) Leadership walk-arounds consisted of the CEO, CNO, and CMS visiting each unit that reported a CLABSI as soon as it was reported (instead of the month end when cumulative reports become available) to discuss what went wrong and what could be corrected with the local unit teams. (2) The CEO had a 1-to-1 discussion with the nursing leadership regarding the monthly CLABSI rates with clear goal setting for the nursing teams. (3) Daily feedback on the practices as reviewed in the observational audits by the infection control team (ie, infection control nurses) was provided to the ICU teams through the ICO and CMS to the individual practitioners (both nurses and doctors). Results: Metrics were collected for both the process measures as well as outcome measures. The CLABSI outcome measure dropped from a mean of 4 per 1,000 CVC days before the intervention to a mean of 1 per 1,000 CVC days after the intervention, both calculated for a 6-month period. The compliance to hand hygiene as per the WHO 5 Moments improved from a mean of 79% to 86%, and the compliance to safe injection practices improved from 76% to 95%. Noncompliant HCWs observed via the daily feedback system dropped from 16–20 HCWs per week at the start of the intervention to 5–6 HCWs per week by the end of 6 months. The environmental cleaning scores (using glow-gel scores with the CDC environmental cleaning tool) remained at an average of 85%. Conclusions: Feedback is the backbone of most of the interventions of quality and infection control teams of healthcare organizations. Increased frequency and feedback from senior management can overcome inertia in improving practices on the ground level. This method could be more cost-effective at reducing CLABSIs than engineered devices.

Funding: None

Disclosures: None