Advocating for the Right Product and Program Leads to Lower CLABSI Rate

Central line-associated bloodstream infections (CLABSIs) cause the highest number of preventable deaths among healthcare-associated infections (HAIs), with a mortality rate of up to 25% and a cost as high as $94,900 per case.^1,2

Using a standardized sterile dressing change system helps promote sterile maintenance of a catheter, reducing CLABSI risk factors.² The right dressing change system can also empower nurses to follow best practices and reduce time spent on dressing changes.

These significant benefits motivated Scott Bernshausen, MAM, BSN, RN, CIC, ASSE 12080, system director of infection prevention and control at the Medical University of South Carolina (MUSC Health), to partner with Medline on a journey to implement a standardized central venous catheter (CVC) dressing change kit from Medline.

The challenge

Inconsistent CVC dressing change kits and resistance to product transition
One of the primary challenges to preventing CLABSIs at MUSC was the lack of a standardized sterile dressing change system across its hospitals. In 2022, when Bernshausen and his team began work toward standardization, each MUSC hospital operated independently. The disconnect led to inconsistencies in infection prevention practices and the products used.

“We wanted to put in place controls to help our care team members do the right thing the first time, because it only requires one contamination to create that patient harm,” Bernshausen stresses.

“The turnover in hospitals is so high these days, so you really want consistency.”—Scott Bernshausen, MAM, BSN, RN, CIC, ASSE 12080

The other big hurdle was the resistance to cost when it came to implementing a new dressing change system. “It was important to us to justify a higher upfront cost by educating our partners on the financial impact due to infections, such as lost funding, increased patient stay and overall patient experience.”

He also pointed out that the overall confusion at having more than a dozen different CVC dressing change systems was hard on nurses, in terms of confidence to follow best practices, time spent on the dressing change and consistency in practice.

20% decrease in CLABSIs with the the Medline CVS dressing change kit³

“The intersection of supply chain and quality is where true healthcare efficiency happens,” says Austin Zoeller, MBA,

AVP, sourcing and contracting at MUSC. “When we collaborate with clinical leadership to streamline product selection efforts, we strengthen the supply chain and reduce care variation, which directly supports better patient outcomes, reduces unnecessary costs, and enhances workflows for frontline staff. We understand that behind every supply decision is a patient who deserves the best care possible.”

The action

Seeking out the frontline voices
To address the challenges, the first step Bernshausen took was to organize a product “road show.” The road show tapped into the knowledge that impact begins with a bedside-first approach. The road show allowed frontline care team members to examine four different CVC dressing kit options. Anywhere from 30 to 70 nurses came through at each facility, dropping their votes in a box at the end of the line.

There were various kits for review, including the CVC dressing change kit from Medline. Developed by nurses for nurses, Medline’s kit organizes components in order of use, guiding clinicians through best practice sterile dressing changes and line access procedures. Instructions for use of each component and images that go with them are customizable and available on the sterile field at the point of use for the nurse.

The Association for Safe Aseptic Practice has certified the Medline CVC dressing change kit with ANTT Accreditation. As
of 2025, Medline’s CVC dressing change kit is fully compliant and in support of ANTT® Key-Part Protection.

The end goal was to recommend the optimal dressing kit, and Bernshausen wanted to make sure he had backing and support from the nurses who would be using these kits on a daily basis. “Typically, less than 2% of nurses actually get to even touch a product before it’s implemented,” he says.

Medline’s CVC dressing change kit was deemed the favored choice. “They liked it because it makes dressing change easy to do correctly,” Bernshausen says.

Presenting the data

The next step was sharing the results of the road show with leadership, along with the clinical and financial rationale for implementing the new kit. It started by humanizing the challenge to reduce CLABSIs. “We focused it all on the patient,” Bernshausen says.

“Typically, less than 2% of nurses actually get to even touch a product before it’s implemented.”

“We used icons of humans to represent the number of infections throughout the system.” He marked some to indicate how many of those died. “I wanted to show, this is the harm that we’ve caused our patients.” He concluded saying that leadership had an opportunity to reduce the negative impact of having multiple CVC dressing change kits. And, of course, he emphasized the kit that was preferred by the frontline nurses.

The outcome

Reducing CLABSI risk and empowering nurses

“Overall the Medline CVC dressing change kit has been wildly successful,” Bernshausen says. The implementation of the new kit and partnership with Medline to educate and support the care team members through the transition led to a significant reduction in CLABSIs across the MUSC system. In the calendar year 2024, MUSC reported 20% less CLABSIs.

Once the decision was made to use the new kit, nursing educators worked with Medline partners to help educate care team members prior to the go-live, ensuring implementation went smoothly.

The secret to MUSC’s success? “You have to have a holistic approach,” Bernshausen says. “Make sure all the right stakeholders are at the table, from both a project management and change implementation perspective.” He says this is just the beginning of how they’ll see the Medline CVC dressing change kit help reduce CLABSIs.

Tips to using a holistic approach to materials change management

1. Be persistent: Change management takes determination and persistence, as demonstrated
by the efforts to get leadership on board with the Medline CVC dressing change kit.

2. Identify barriers: Spot potential barriers early so you can either remove them or find ways to jump through the hoops, always keeping your goal in sight.

3. Engage care team members: Get frontline team members involved in the decision-making process from the start. Make sure they have an opportunity to touch and try the product. Their input is crucial and carries a lot of weight in the final decision.

4. Use a data-driven approach: Leadership and value analysis committees appreciate numbers. Show them results of frontline care team member reviews, as well as data that indicates the clinical challenge and how the preferred product can reduce patient harm and the costs associated with it.

5. Maintain a patient-centered focus: Build your case by starting with statistics that humanize the issue, emphasizing that it’s not just about the upfront product cost, but the cost in patient harm, treatment and organization reputation.

6. Collaborate on education: After getting input from the frontline, involve educators to help with smooth implementation and training for the new products.

7. Improve systemization: Start a more systematic approach to materials management to improve efficiency.

8. Highlight positive outcomes: Promote the success of the initiative and the importance of frontline involvement by highlighting the positive results.