Evidence-based insertion and maintenance bundles are effective in reducing the incidence of central line-associated bloodstream infections (CLABSI) in intensive care unit (ICU) settings. We studied the adoption and compliance of CLABSI prevention bundle programs and CLABSI rates in ICUs in a large network of acute care hospitals across Canada.

We evaluated an enhanced role in comprehensive geriatric assessment for community-nurse case managers. Following practicum education in geriatric assessment, two community-nurse case managers conducted assessments of frail older clients and served as a resource for their case-manager teams. Impacts on their colleagues' assessment skills were investigated in a non-randomized, controlled trial. Intervention-group case managers had higher confidence in assessing and managing the health and social concerns of older persons, greater use of standard assessment tools, and higher case-study assessment scores, than did control-group case managers. Case managers reported that interaction with the enhanced-role case managers had enhanced their skills and benefited clients; family physicians reported that improved patient outcomes had resulted from the assessment information received. Community case managers with enhanced training in geriatric assessment can have a valuable clinical and educational role. Issues include resource implications and integrating the enhanced role into home care operations.