Reducing CLABSI in a Tertiary ICU: A Quasi-Experimental Study of a Layered Quality Improvement Initiative

Implementing a structured, layered quality improvement approach was associated with a significant decrease in CLABSI rates. While the study design does not allow for isolating the effects of individual components-such as the 4E framework, the checklist, or the changes in insertion practices-the results strongly suggest that a systematic strategy which combines a guiding framework, practical tools, and adherence to evidence-based practices effectively enhances patient safety in complex clinical settings.