Simultaneous placement of multiple central lines increases central line–associated bloodstream infection rates

2013 ◽  
Vol 41 (2) ◽  
pp. 113-117 ◽  
Author(s):  
Simone Scheithauer ◽  
Helga Häfner ◽  
Jörg Schröder ◽  
Alexander Koch ◽  
Vedranka Krizanovic ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Central Line ◽  
Infection Rates ◽  
Central Lines

scholarly journals 2098. Reduction of Central-Line-associated Bloodstream Infection Rates: Impact of Minimizing Blood Cultures from Central Lines

2018 ◽  
Vol 5 (suppl_1) ◽  
pp. S615-S615
Author(s):  
Nisreen Murad ◽  
Ana C Bardossy ◽  
Ryan Shelters ◽  
Eman Chami ◽  
Stephanie Schuldt ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Central Line ◽  
Blood Cultures ◽  
Infection Rates ◽  
Central Lines

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 Impact of Medicare’s Hospital-Acquired Condition Policy on Infections in Safety Net and Non–Safety Net Hospitals

2015 ◽  
Vol 36 (6) ◽  
pp. 649-655 ◽  
Author(s):  
Louise Elaine Vaz ◽  
Kenneth P. Kleinman ◽  
Alison Tse Kawai ◽  
Robert Jin ◽  
William J. Kassler ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Financial Incentives ◽  
Safety Net ◽  
The United States ◽  
Central Line ◽  
Unintended Consequences ◽  
Infection Rates ◽  
Healthcare Associated Infection ◽  
Hospital Acquired Conditions ◽  
Hospital Acquired

BACKGROUNDPolicymakers may wish to align healthcare payment and quality of care while minimizing unintended consequences, particularly for safety net hospitals.OBJECTIVETo determine whether the 2008 Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy had a differential impact on targeted healthcare-associated infection rates in safety net compared with non–safety net hospitals.DESIGNInterrupted time-series design.SETTING AND PARTICIPANTSNonfederal acute care hospitals that reported central line–associated bloodstream infection and ventilator-associated pneumonia rates to the Centers for Disease Control and Prevention’s National Health Safety Network from July 1, 2007, through December 31, 2013.RESULTSWe did not observe changes in the slope of targeted infection rates in the postpolicy period compared with the prepolicy period for either safety net (postpolicy vs prepolicy ratio, 0.96 [95% CI, 0.84–1.09]) or non–safety net (0.99 [0.90–1.10]) hospitals. Controlling for prepolicy secular trends, we did not detect differences in an immediate change at the time of the policy between safety net and non–safety net hospitals (P for 2-way interaction, .87).CONCLUSIONSThe Centers for Medicare and Medicaid Services Hospital-Acquired Conditions policy did not have an impact, either positive or negative, on already declining rates of central line–associated bloodstream infection in safety net or non–safety net hospitals. Continued evaluations of the broad impact of payment policies on safety net hospitals will remain important as the use of financial incentives and penalties continues to expand in the United States.Infect Control Hosp Epidemiol 2015;00(0): 1–7

Types of Interventions

2021 ◽  
pp. 40-51
Author(s):  
Jennifer Meddings ◽  
Vineet Chopra ◽  
Sanjay Saint
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Bloodstream Infection ◽  
Infection Prevention ◽  
Central Line ◽  
Peripherally Inserted Central Catheters ◽  
Trade Off ◽  
Central Lines ◽  
The Past ◽  
Central Catheters

Prevention of central line–associated bloodstream infection (CLABSI), while initially making great strides in 2003, has declined as use of peripherally inserted central catheters (PICCs) has grown tremendously over the past two decades. The convenience of a PICC has led to sicker patients being treated outside the intensive care unit, and there has been little recognition of a trade-off between benefits and risks after PICC placement. For these reasons, CLABSI prevention has become more challenging. This chapter describes the contents of an infection prevention bundle for CLABSI. In the case of CLABSI, the intervention outlines appropriate and inappropriate uses of central lines. Several new tools are discussed, which help doctors and nurses think through which device is most appropriate for any given patient.

scholarly journals Differences in Central Line–Associated Bloodstream Infection Rates Based on the Criteria Used to Count Central Line Days

JAMA ◽  
2020 ◽  
Vol 323 (2) ◽  
pp. 183 ◽  
Author(s):  
David Scheinker ◽  
Andrew Ward ◽  
Andrew Y. Shin ◽  
Grace M. Lee ◽  
Roshni Mathew ◽  
...  
Keyword(s):  
Bloodstream Infection ◽  
Central Line ◽  
Infection Rates

Impact of International Nosocomial Infection Control Consortium’s multidimensional approach on central line–associated bloodstream infection rates in Bahrain

2019 ◽  
Vol 21 (4) ◽  
pp. 481-489
Author(s):  
Safaa Alkhawaja ◽  
Nermeen Kamal Saeed ◽  
Victor Daniel Rosenthal ◽  
Sana Abdul-Aziz ◽  
Ameena Alsayegh ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Nosocomial Infection ◽  
Infection Control ◽  
Bloodstream Infection ◽  
Infection Rate ◽  
Bloodstream Infections ◽  
Central Line ◽  
Multidimensional Approach ◽  
Infection Rates

Background: Central line–associated bloodstream infections are serious life-threatening infections in the intensive care unit setting. Methods: To analyze 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 rates in Bahrain from January 2013 to December 2016, we conducted a prospective, before-after surveillance, cohort, observational study in one intensive care unit in Bahrain. During baseline, we performed outcome and process surveillance of central line–associated bloodstream infection on 2320 intensive care unit patients, applying Centers for Disease Control and Prevention’s National Healthcare Safety Network definitions. During intervention, we implemented IMA through ISOS, including (1) a bundle of infection prevention interventions, (2) education, (3) outcome surveillance, (4) process surveillance, (5) feedback on central line–associated bloodstream infection 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 central line–associated bloodstream infection rate. Results: During baseline, 672 central line days and 7 central line–associated bloodstream infections were recorded, accounting for 10.4 central line–associated bloodstream infections per 1000 central line days. During intervention, 13,020 central line days and 48 central line–associated bloodstream infections were recorded. After the second year, there was a sustained 89% cumulative central line–associated bloodstream infection rate reduction to 1.2 central line–associated bloodstream infections per 1000 central line days (incidence density rate, 0.11; 95% confidence interval 0.1–0.3; p, 0.001). The average extra length of stay of patients with central line–associated bloodstream infection was 23.3 days, and due to the reduction of central line–associated bloodstream infections, 367 days of hospitalization were saved, amounting to a reduction in hospitalization costs of US$1,100,553. Conclusion: Implementing IMA was associated with a significant reduction in the central line–associated bloodstream infection rate in Bahrain.

Impact of multiple concurrent central lines on central-line–associated bloodstream infection rates

2019 ◽  
Vol 40 (9) ◽  
pp. 1019-1023 ◽  
Author(s):  
Jesse Couk ◽  
Sheri Chernetsky Tejedor ◽  
James P. Steinberg ◽  
Chad Robichaux ◽  
Jesse T. Jacob
Keyword(s):  
Bloodstream Infection ◽  
Hospital Admissions ◽  
Pay For Performance ◽  
Descriptive Analysis ◽  
Cohort Analysis ◽  
Severity Of Illness ◽  
Central Line ◽  
Central Lines ◽  
Academic Medical ◽  
Retrospective Cohort Analysis

AbstractBackground:The current methodology for calculating central-line–associated bloodstream infection (CLABSI) rates, used for pay-for-performance measures, does not account for multiple concurrent central lines.Objective:To compare CLABSI rates using standard National Healthcare Safety Network (NHSN) denominators to rates accounting for multiple concurrent central lines.Design:Descriptive analysis and retrospective cohort analysis.Methods:We identified all adult patients with central lines at 2 academic medical centers over an 18-month period. CLABSI rates were calculated for intensive care units (ICUs) and non-ICUs using the standard NHSN methodology and denominator (a patient could only have 1 central-line day for a given patient day) and a modified denominator (number of central lines in 1 patient in 1 day count as number of line days). We also compared characteristics of patients with and without multiple concurrent central lines.Results:Among 18,521 hospital admissions, there were 156,574 central-line days and 239 CLABSIs (ICU, 105; non-ICU, 134). Our modified denominator reduced CLABSI rates by 25% in ICUs (1.95 vs 1.47 per 1,000 line days) and 6% (1.30 vs 1.22 per 1,000 line days) in non-ICUs. Patients with multiple concurrent central lines were more likely to be in an ICU, to have a longer admission, to have a dialysis catheter, and to have a CLABSI.Conclusions:Using the number of central lines as the denominator decreased CLABSI rates in ICUs by 25%. The presence of multiple concurrent central lines may be a marker of severity of illness. The risk of CLABSI per lumen of a central line is similar in ICUs compared to wards.

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