Value Analysis of Central Line Simulation-Based Education

2021 ◽  
pp. 000313482110111
Author(s):  
Nicholas J. Iglesias ◽  
Taylor P. Williams ◽  
Clifford L. Snyder ◽  
Christian Sommerhalder ◽  
Alexander Perez

Background Central line-associated bloodstream infections (CLABSIs) are preventable complications that pose a significant health risk to patients and place a financial burden on hospitals. Central line simulation-based education (SBE) efforts vary widely in the literature. The aim of this study was to perform a value analysis of published central line SBE and develop a refined method of studying central line SBE. Methods A database search of PubMed Central and Cumulative Index to Nursing and Allied Health Literature (CINAHL) was performed for articles mentioning “Cost and CLABSI,” “Cost and Central line Associated Bloodstream Infections,” and “Cost and Central Line” in their abstract and article body. Articles chosen for qualitative synthesis mentioned “simulation” in their abstract and article body and were analyzed based on the following criteria: infection rate before vs. after SBE, cost of simulation, SBE design including simulator model used, and learner analysis. Results Of 215 articles identified, 23 were analyzed, 10 (43.48%) discussed cost of central line simulation with varying criteria for cost reporting, 8 (34.8%) numerically discussed central line complication rates (7 CLABSIs and 1 pneumothorax), and only 3 (13%) discussed both (Figure). Only 1 addressed the true cost of simulation (including space rental, equipment startup costs, and faculty salary) and its longitudinal effect on CLABSIs. Conclusion Current literature on central line SBE efforts lacks value propositions. Due to the lack of value-based data in the area of central line SBE, the authors propose a cost reporting standard for use by future studies reporting central line SBE costs.

2016 ◽  
Vol 12 (1) ◽  
pp. e83-e87 ◽  
Author(s):  
Jenna Page ◽  
Maureen Tremblay ◽  
Cate Nicholas ◽  
Ted A. James

A targeted educational intervention using a simulated central line care model improved competence in central line care and resulted in decreased CLABSI rates for oncology inpatients.


2020 ◽  
Vol 231 (4) ◽  
pp. e204
Author(s):  
Nicholas J. Iglesias ◽  
Taylor Williams ◽  
Christian Sommerhalder ◽  
Clifford Snyder ◽  
Alexander Perez

2014 ◽  
Vol 23 (9) ◽  
pp. 749-756 ◽  
Author(s):  
Jeffrey H Barsuk ◽  
Elaine R Cohen ◽  
Steven Potts ◽  
Hany Demo ◽  
Shanu Gupta ◽  
...  

2018 ◽  
Vol 46 (1) ◽  
pp. 596-596
Author(s):  
Elise Kumar ◽  
Paul Yodice ◽  
Rezai Fariborz ◽  
Kaitlin Kumar ◽  
Kristin Fless ◽  
...  

2020 ◽  
Vol 41 (S1) ◽  
pp. s343-s344
Author(s):  
Margaret A. Dudeck ◽  
Katherine Allen-Bridson ◽  
Jonathan R. Edwards

Background: The NHSN is the nation’s largest surveillance system for healthcare-associated infections. Since 2011, acute-care hospitals (ACHs) have been required to report intensive care unit (ICU) central-line–associated bloodstream infections (CLABSIs) to the NHSN pursuant to CMS requirements. In 2015, this requirement included general medical, surgical, and medical-surgical wards. Also in 2015, the NHSN implemented a repeat infection timeframe (RIT) that required repeat CLABSIs, in the same patient and admission, to be excluded if onset was within 14 days. This analysis is the first at the national level to describe repeat CLABSIs. Methods: Index CLABSIs reported in ACH ICUs and select wards during 2015–2108 were included, in addition to repeat CLABSIs occurring at any location during the same period. CLABSIs were stratified into 2 groups: single and repeat CLABSIs. The repeat CLABSI group included the index CLABSI and subsequent CLABSI(s) reported for the same patient. Up to 5 CLABSIs were included for a single patient. Pathogen analyses were limited to the first pathogen reported for each CLABSI, which is considered to be the most important cause of the event. Likelihood ratio χ2 tests were used to determine differences in proportions. Results: Of the 70,214 CLABSIs reported, 5,983 (8.5%) were repeat CLABSIs. Of 3,264 nonindex CLABSIs, 425 (13%) were identified in non-ICU or non-select ward locations. Staphylococcus aureus was the most common pathogen in both the single and repeat CLABSI groups (14.2% and 12%, respectively) (Fig. 1). Compared to all other pathogens, CLABSIs reported with Candida spp were less likely in a repeat CLABSI event than in a single CLABSI event (P < .0001). Insertion-related organisms were more likely to be associated with single CLABSIs than repeat CLABSIs (P < .0001) (Fig. 2). Alternatively, Enterococcus spp or Klebsiella pneumoniae and K. oxytoca were more likely to be associated with repeat CLABSIs than single CLABSIs (P < .0001). Conclusions: This analysis highlights differences in the aggregate pathogen distributions comparing single versus repeat CLABSIs. Assessing the pathogens associated with repeat CLABSIs may offer another way to assess the success of CLABSI prevention efforts (eg, clean insertion practices). Pathogens such as Enterococcus spp and Klebsiella spp demonstrate a greater association with repeat CLABSIs. Thus, instituting prevention efforts focused on these organisms may warrant greater attention and could impact the likelihood of repeat CLABSIs. Additional analysis of patient-specific pathogens identified in the repeat CLABSI group may yield further clarification.Funding: NoneDisclosures: None


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