Effect of Accounting for Multiple Concurrent Catheters on Central Line–Associated Bloodstream Infection Rates: Practical Data Supporting a Theoretical Concern

2011 ◽  
Vol 32 (2) ◽  
pp. 121-124 ◽  
Author(s):  
Rebecca A. Aslakson ◽  
Mark Romig ◽  
Samuel M. Galvagno ◽  
Elizabeth Colantuoni ◽  
Sara E. Cosgrove ◽  
...  
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Conventional Method ◽  
Central Line ◽  
New Method ◽  
Surgical Intensive Care Unit ◽  
The Difference ◽  
Clabsi Rate

Background.Central line-associated bloodstream infection (CLABSI) rates are gaining importance as they become publicly reported metrics and potential pay-for-performance indicators. However, the current conventional method by which they are calculated may be misleading and unfairly penalize high-acuity care settings, where patients often have multiple consurrent central venous catheters (CVCs).Objective.We compared the conventional method of calculating CLABSI rates, in which the number of catheter-days is used (1 patient with n catheters for 1 day has 1 catheter-day), with a new method that accounts for multiple concurrent catheters (1 patient with n catheters for 1 day has n catheter-days), to determine whether the difference appreciably changes the estimated CLABSI rate.Design.Cross-sectional survey.Setting.Academic, tertiary care hospital.Patients.Adult patients who were consecutively admitted from June 10 through July 9, 2009, to a cardiac-surgical intensive care unit and a surgical intensive and surgical intermediate care unit.Results.Using the conventional method, we counted 485 catheter-days throughout the study period, with a daily mean of 18.6 catheter-days (95% confidence interval, 17.2-20.0 catheter-days) in the 2 intensive care units. In contrast, the new method identified 745 catheter-days, with a daily mean of 27.5 catheter-days (95% confidence interval, 25.6-30.3) in the 2 intensive care units. The difference was statistically significant (P < .001). The new method that accounted for multiple concurrent CVCs resulted in a 53.6% increase in the number of catheter-days; this increased denominator decreases the calculated CLABSI rate by 36%.Conclusions.The undercounting of catheter-days for patients with multiple concurrent CVCs that occurs when the conventional method of calculating CLABSI rates is used inflates the CLABSI rate for care settings that have a high CVC burden and may not adjust for underlying medical illness. Additional research is needed to validate and generalize our findings.

Impact of the International Nosocomial Infection Control Consortium (INICC)’s Multidimensional Approach on Rates of Central Line-Associated Bloodstream Infection in 14 Intensive Care Units in 11 Hospitals of 5 Cities in Argentina

2018 ◽  
Vol 39 (4) ◽  
pp. 445-451 ◽  
Author(s):  
Victor Daniel Rosenthal ◽  
Javier Desse ◽  
Diego Marcelo Maurizi ◽  
Gustavo Jorge Chaparro ◽  
Pablo Wenceslao Orellano ◽  
...  
Keyword(s):  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Density ◽  
Multidimensional Approach ◽  
The Impact ◽  
Clabsi Rate

OBJECTIVETo analyze the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and the INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in 14 intensive care units (ICUs) in Argentina from January 2014 to April 2017.DESIGNThis prospective, pre–post surveillance study of 3,940 ICU patients was conducted in 11 hospitals in 5 cities in Argentina. During our baseline evaluation, we performed outcome and process surveillance of CLABSI applying Centers for Disease Control and Prevention/National Health Safety Network (CDC/NHSN) definitions. During the intervention, we implemented the IMA through ISOS: (1) a bundle of infection prevention practice interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on CLABSI rates and consequences, and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed using a logistic regression model to estimate the effect of the intervention on the CLABSI rate.RESULTSDuring the baseline period, 5,118 CL days and 49 CLABSIs were recorded, for a rate of 9.6 CLABSIs per 1,000 central-line (CL) days. During the intervention, 15,659 CL days and 68 CLABSIs were recorded, for a rate of 4.1 CLABSIs per 1,000 CL days. The CLABSI rate was reduced by 57% (incidence density rate: 0.43; 95% confidence interval, 0.34–0.6; P<.001).CONCLUSIONSImplementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in ICUs in Argentina.Infect Control Hosp Epidemiol 2018;39:445–451

scholarly journals Prospective multicentre study in intensive care units in five cities from the Kingdom of Saudi Arabia: Impact of the International Nosocomial Infection Control Consortium (INICC) multidimensional approach on rates of central line-associated bloodstream infection

2016 ◽  
Vol 18 (1) ◽  
pp. 25-34 ◽  
Author(s):  
Hail M Al-Abdely ◽  
Areej Dhafer Alshehri ◽  
Victor Daniel Rosenthal ◽  
Yassir Khidir Mohammed ◽  
Weam Banjar ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Density ◽  
Multidimensional Approach ◽  
Clabsi Rate

Objective: To analyse the impact of the International Nosocomial Infection Control Consortium (INICC) Multidimensional Approach (IMA) and INICC Surveillance Online System (ISOS) on central line-associated bloodstream infection (CLABSI) rates in five intensive care units (ICUs) from October 2013 to September 2015. Design: Prospective, before-after surveillance study of 3769 patients hospitalised in four adult ICUs and one paediatric ICU in five hospitals in five cities. During baseline, we performed outcome and process surveillance of CLABSI applying CDC/NHSN definitions. During intervention, we implemented IMA and ISOS, which included: (1) a bundle of infection prevention practice interventions; (2) education; (3) outcome surveillance; (4) process surveillance; (5) feedback on CLABSI rates and consequences; and (6) performance feedback of process surveillance. Bivariate and multivariate regression analyses were performed. Results: During baseline, 4468 central line (CL) days and 31 CLABSIs were recorded, accounting for 6.9 CLABSIs per 1000 CL-days. During intervention, 12,027 CL-days and 37 CLABSIs were recorded, accounting for 3.1 CLABSIs per 1000 CL-days. The CLABSI rate was reduced by 56% (incidence-density rate, 0.44; 95% confidence interval, 0.28–0.72; P = 0.001). Conclusions: Implementing IMA through ISOS was associated with a significant reduction in the CLABSI rate in the ICUs of Saudi Arabia.

Impact of an Education Program on the Incidence of Central Line-Associated Bloodstream Infection in 2 Medical-Surgical Intensive Care Units in Brazil

2008 ◽  
Vol 29 (12) ◽  
pp. 1171-1173 ◽  
Author(s):  
Solange L. Santana ◽  
Guilherme H. C. Furtado ◽  
Sérgio Barsanti Wey ◽  
Eduardo A. S. Medeiros
Keyword(s):  
Intensive Care ◽  
Confidence Interval ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Education Program ◽  
Odds Ratio ◽  
Intervention Study ◽  
Central Line ◽  
Surgical Intensive Care ◽  
The Impact

An intervention study was undertaken to evaluate the impact of an education program on the incidence of central line–associated bloodstream infection (CLABSI) in 2 intensive care units. There was a nonsignificant reduction in the incidence of CLABSI (odds ratio, 0.46 [95% confidence interval, 0.21–1.02]; P = .04) despite a significant increase in knowledge of CLABSI prevention by the staff of both intensive care units after the education program.

scholarly journals Impact of State Reporting Laws on Central Line-Associated Bloodstream Infection Rates in U.S. Adult Intensive Care Units

2016 ◽  
Vol 52 (3) ◽  
pp. 1079-1098 ◽  
Author(s):  
Hangsheng Liu ◽  
Carolyn T. A. Herzig ◽  
Andrew W. Dick ◽  
E. Yoko Furuya ◽  
Elaine Larson ◽  
...  
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Infection Rates ◽  
Reporting Laws

scholarly journals Surveillance Length and Validity of Benchmarks for Central Line-Associated Bloodstream Infection Incidence Rates in Intensive Care Units

PLoS ONE ◽  
2012 ◽  
Vol 7 (5) ◽  
pp. e36582 ◽  
Author(s):  
Patricia S. Fontela ◽  
Caroline Quach ◽  
David Buckeridge ◽  
Madukhar Pai ◽  
Robert W. Platt
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Central Line ◽  
Incidence Rates ◽  
Infection Incidence

scholarly journals A COMPREHENSIVE UPDATE ON INCIDENCE, PREVALENCE AND COMPLEX ETIOLOGY OF CENTRAL LINE–ASSOCIATED BLOODSTREAM INFECTION IN PEDIATRIC INTENSIVE CARE UNITS IN KING SAUD MEDICAL CITY

2021 ◽  
Vol 9 (5) ◽  
pp. 56-63
Author(s):  
Juhaina Abdulrahiem ◽  
Asia Sultan ◽  
Faisl Alaklobi ◽  
Hala Amer ◽  
Hind Alzoman
Keyword(s):  
Intensive Care ◽  
Bloodstream Infection ◽  
Intensive Care Units ◽  
Age Groups ◽  
Pediatric Intensive Care ◽  
Central Line ◽  
Central Lines ◽  
Medical City ◽  
Underlying Diseases ◽  
Paediatric Intensive Care Units

Central Line Associated Bloodstream Infection (CLABSI) is a type of bloodstream infection that is caused by microorganisms after the insertion of central lines. Paediatric Intensive Care Units have been studied to conduct this research on CLABSI in children from 2 to 15 years old. Children have been divided in two age groups that are 2-5 and 5-15 years. The Royal Children’s Hospital, Melbourne has been chosen as a sample of this besides other five hospitals of Australia. A total of 350 patients are studied in the course of this research and 216 among them were inserted with central lines. Bloodstream infection has been identified in 49 patients from these 216 patients and CLABSI occurred in 75.51% of them that is 37 patients. Associated microorganisms and other underlying diseases are listed in this study to develop an idea about factors responsible for CLABSI.

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