Your article “Nurses in Charge” (Dec. 6, p. 28) shines a much-needed light on the contributions nurses can make to quality improvement at hospitals that recognize their insights and passion. Beyond the inspiring examples mentioned in your piece, nurses can also lead initiatives in highly scientific, critical areas such as infection control—as our experience at Broward Health Coral Springs (Fla.) Medical Center has shown. We were having trouble in further reducing our rate of central line-associated bloodstream infections (CLABSIs), despite prodigious efforts to do so. The leadership of our regional manager of epidemiology, Ava Dobin, a registered nurse, helped save the day. Under Dobin's guidance, we implemented a well-designed new protocol that has nearly eliminated CLABSIs at our institution. There has been only one in eight months, a rare occurrence at any U.S. hospital. Because Dobin understood nursing behavior, she believed that our protocol for manually disinfecting the tops and threads of intravenous needleless connectors was at the heart of the problem. She encouraged us to trial an engineered disinfection cap to replace the manual protocol between line accesses. This made compliance verification as simple as observing that the cap is in place. Except for one, CLABSIs have disappeared, and the new best practice has helped us achieve cost savings too. It was nursing knowledge and leadership that led to this success.
Drew GrossmanCEOBroward Health Coral Springs (Fla.) Medical Center