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clabsi pdf A central line (CL) that has been in place > 2 consecutive calendar days following the first access of the central line, in an inpatient location, during the current admission. 8 If proper insertion is the foundation of a strong CLABSI preven-tion program, then solid maintenance What is a Central Line-Associated Bloodstream Infection, or CLABSI? A central line, like the name implies, is a catheter that gains direct entry into the bloodstream with the tip of a line sitting either within the superior vena cava or inferior vena cava, or within one of the great vessels of the neck. Between the pre- and postintervention periods, device utilization decreased from 24. The overall CLABSI rate decreased from 11. Figure 1. 2. (17) In an experimental study, Hong (2013) compared catheter hub disinfection with 3. 098) and national benchmark CLABSI. e. Health care personnel should understand the appropriate care and maintenance needed to prevent CLABSI infection after central catheter insertion as well as the proper techniques in postinsertion care. The more than 1,000 adult ICUs that participated in AHRQ’s nationwide CUSP for CLABSI project reduced the rate of CLABSI by 41%, prevented more than 2,100 of these infections, saved more than 500 lives, and avoided more than $36 million in excess costs. 03 1. BMJ Qual Saf. ICU CLABSI Rate NHSN ICU Benchmark 2013 CDC National Healthcare Safety Network (NHSN) Benchmark: Critical Care Units, Medical/Surgical -major teaching mean 1. pdf from NURS 152 at University of Washington, Tacoma. )Any diagnosed CLABSIs should be treated as life-threatening, and antibiotics specific to the organism should be initiated. JAMA. Eligible for CLABSI events until the day after removal from the body or patient Skin antisepsis is a cornerstone of CLABSI prevention. S. 482 (2019), with an overall specific CLABSI rate of 0. 0 No reduce incidence of CLABSI Provide examples of legal cases involving vascular access device infections with practical application for healthcare facilities Healthcare-associated infections (HAIs) are among the top causes of unnecessary illnesses and deaths in the United States HAIs are infections patients get while in a hospital or Created Date: 6/28/2012 7:09:07 PM CLABSI 0. D. 0 No Conclusion Adult/Ped Wards 0 Less than 1. Reference: Pearlman SA. 2 Assuming an average CLABSI rate of 5. pdf from NURS 152 at University of Washington, Tacoma. In 2007, the state of Tennessee became a leader in the CLABSI prevention initiative, mandating daily central line necessity review and the reporting of monthly CLABSIs by acute care facilities, including pediatric facilities, to the state and CDC the following year. CLABSI PREVENTION Central Line-Associated Bloodstream Infection Risks & Prevention This assessment worksheet provides a method to measure the level of implementation of an organization’s prevention program for central-line associated bloodstream infections (CLABSI). 868 0. Experts estimate 30,000 patients per year lose their lives to these infections. However, quality healthcare necessitates a safer service that poses no harm to the patient. This law was Central Line-Associated Bloodstream Infections (CLABSI) Table 4. The calculation is: 5. Peer tutoring may be an efficient and effective method that is A central line bloodstream infection (CLABSI) occurs when bacteria or other germs enter the patient’s central line and then enter into their bloodstream. 46% . 040 0. The CLABSI Epidemiology In recent prevalence study1: 28% of acute care patients had a central line 14% of HAIs were BSI All BSIs identified were CLABSI Estimated 41,000 CLABSI annually hospital-wide2 18,000 CLABSI annually in ICUs Cost varies (2007 dollars)3: $7,000 to $29,000 per episode greatest effect on CLABSI incidence –Handwashing –Using full barrier precautions during insertion –Cleaning the skin with chlorhexidine –Avoiding the femoral site if possible –Removing unnecessary central venous catheters Intervention implemented from Mar 2004 –Sep 2005 –Pre- and post-implementation CLABSI rates were measured HA-CLABSI rate per 1000 catheter days ( line) ˇ HA-CLABSI rates in high-risk units (HRUs) a­er introduction of SwabCap Nov-Dec 2011 Jan-Feb 2012 Mar-Apr 2012 May-Jun 2012 Jul-Aug 2012 Sep-Oct 2012 Nov-Dec 2012 One study showed that use of SwabCap resulted in a 34% decrease in HA-CLABSI. Mortality rates from CLABSI are 12% to 25% and significantly increase cost and hospital length of stay (Centers for Disease Control and Prevention [CDC], 2011). Additional interventions a View CLABSI QI PROJECT NURS 152. • When a CLABSI occurs well after the 96-hour mark, contamination through the needleless connector is likely the culprit. Number of Observed and Predicted CLABSI Infections by ICU and Ward Type, Jan-Jun 2018 Unit Type Observed Infections Predicted Infections How Does This Facility Compare to the National Experience? Adult/Ped ICUs 1 Less than 1. While neonates often require prolonged central venous access and suffer from impaired immunity which increases the risk of CLABSI, this review demonstrates the journey to zero is feasible. CLABSI: The Burning Platform •CLABSI is our most common HAC. Pronovost 1 Published online: 2 June 2015 # Springer Science+Business Media New York 2015 Abstract Central line-associated bloodstream infections Keywords Central line-associated bloodstream Central Line-Associated Bloodstream Infections (CLABSI) Table 4. 89 SSI HYST Surgical Site Infection 1. 616 1. 2% to 1. Surveillance period The 2019 CLABSI surveillance period will begin January 1, 2019 and continue to December 31, 2019 inclusive. 47/1,000 line days. It should be removed and replaced at a different site. Monthly preimplementation CLABSI rates ranged from 0 to 71. Prevent Central Line-Associated Bloodstream Infections Did You Know? 1/3 from CLABSI 100,000 estimated HAI Deaths ICU))) countries In these countries the rates of healthcare-associated infections (HAIs) related Uncovering the cause of the CLABSI and developing an action plan are key steps to preventing future infections. This policy change can represent a significant financial burden to the hospital because increased hospital costs due to CLABSI can be as much as $23,000 per case. 3 ˜ ˚ ˛ ˝ ˙ ˆ HA-CLABSI rate per 1000 catheter days Neonates are at high risk for central line associated bloodstream infections (CLABSI). 0 No Conclusion Adult/Ped Wards 0 Less than 1. 13 10 INFECTION (CLABSI) FACT SHEET Overview A central line, or central venous catheter, is a narrow tube that is placed in a large vein in the neck, chest, groin or arm to deliver fluids or medications. 1 Interpreting Criterion 1 and Criterion 2 8 3. Page 3 of 24 . g. 17 2. 040 0. Methods to decrease incidence, and prophylactic management are promising although good methods are available, the reduction in CLABSI rates will lead to decreased mortality and morbidity among the affected b. It should be removed and replaced at a different site. 774 0. 2,13-16 CLABSI has transitioned from a common ICU complication to a “never event. Tubing, Injection Ports, Catheter Entry 3. first. 352 0. March 12, 2019 • At over $45,000 per patient, CLABSI is the costliest healthcare-related infection in the US3 • Annual estimated cost of more than $1 billion4 COMMON • 250,000 cases a year in the US4 FATAL • 33,000 deaths a year in the US4 • 90 deaths a day CLABSI 0. 15 per case and a relative risk of 2. These long, flexible catheters empty in or near the heart and are important ways for treating or monitoring many conditions. (See Specimen collection: Best practices. INTRODUCTION A CLABSI is a serious infection that occurs when microbes enter the bloodstream through a central line. comparison of clabsi risk between piccs and cvcs in adults 909 figure 1. 2 million in excess costs saved. Rationale: An estimated 248,000 bloodstream infections occur in U. Results: The intervention successfully reduced the CLABSI rate from 1. CLABSI rates. Ensure that all healthcare personnel involved in catheter insertion and maintenance complete an educational program regarding basic practices to effective best practices for CLABSI reduced the CLABSI rate by 74% statewide. Pittet D, Tarara D, Wenzel RP. * Increased costs, LOS, mortality *CDC National and State Healthcare-Associated Infections Progress Report, published March 2014, Sites of positive blood cultures, within 48 hours after CLABSI onset (Check all that apply) ☐ Periphery ☐ CLABSI Line ☐ Other line ☐ Unlabeled ☐ Unknown Number of positive blood cultures:______ prevent CLABSI. Multiple CLABSI reduction strategies were implemented, so we are unable to attribute the results to a single intervention. 3 per 1000 catheter days and your clinical area has 2500 catheter days per year, you have 13 preventable CLABSIs every year. S. , 2011). Assessment & Site Care b. 20 Central line-associated BSI (CLABSI): A laboratory confirmed bloodstream infection where an eligible BSI organism is identified, and an . 8/1,000 central line days for critical care areas and 1. Scenario 1 • 2/1: Mr. 3 per 1,000 catheter days and an 2 Classification of CLABSI 6 2. 0 No and products to prevent CLABSI and CAUTI. 028). Many clinicians reflexively ‘pan culture’ patients when their clinical status worsens. first. For example, the medical center that calcu-lated the lowest CLABSI rate using tra-ditional surveillance methods had the highest rate when the computer algo-rithm was used. 613 0. 2011; 6(1): e15452. • CLABSI rates decreased 58% from 2. 568 0. 05 to 22. Soufir L et al. 5% chlorhexidine preparation with alcohol for skin antisepsis during CVC insertion specific CLABSI data are available from the VDH Healthcare-Associated Infections Program upon request. 66/1000 days. 02 Dimick [26] 9 251 55. )Any diagnosed CLABSIs should be treated as life-threatening, and antibiotics specific to the organism should be initiated. Educate staff members about how to reduce CLABSI 3. 48 -2. The most powerful predictors of CLABSI were hematological cancer (3 points) or prior CLABSI within 3 months of PICC placement (2 points). • Beginning in 2015, CDC will collect data in order to update the standard What to do when a CLABSI occurs. The third hospital was prompted by their corporate parent to address CLABSI. Implement Teamwork & Communication Tools CLABSI CUSP 1. 33 Higuera [18] 55 55 41. CLABSI is a type of healthcare-associated infection (HAI). The CLABSI bundle elements are largely supported by CDC/HICPAC, APIC, SHEA, and IDSA guidance Background. for CLABSI prevention. The predicted probability of CLABSI for PICC dwell times of 6 to 40 days ranged from 0. 0 No Conclusion Adult/Ped Wards 0 Less than 1. CLABSI GUIDING PRINCIPLES FOR REDUCING CENTRAL LINE–ASSOCIATED BLOODSTREAM INFECTIONS NYS PARTNERSHIP FOR PATIENTS INNOVATE ENGAGE • Ensure senior administrative and clinical leadership support for reducing CLABSIs. is present on the LCBI DOE or the day before. The catheter had been in place > 2 days and an HAI occurring on the day of device discontinuation or the following calendar day is considered a device-associated infection. Weighted Reduction in CLABSI Across Multiple Measures . 49. 613 0. 6–9-ment of CLABSI in children, outside the Central Line-Associated Bloodstream Infections (CLABSI) Table 4. Hospital reported inpatient unit locations in NHSN are determined by hospital type (black bars, the hospitals used CLABSI reduction as one of their first attempts to employ Six Sigma methodology for quality improvement. 00 1. 040 0. Despite their involvement in the process CLABSI (administrative measures identified only 6 percent in one study and 33 percent in another study of those who actually had a CLABSI occurrence), effectively ruling out the use of administrative data at the current time as a legitimate approach to generating state-level, insurance-specific rates. Senior Executive Partnership 4. 120, 0. 00 CLABSI from being assigned to concurrent urine cultures and other sites such as VAP. In 2000, the estimated number of CLABSI in intensive care units (ICUs) in the United States per year was 80,000. CLABSI in the NICU * Kaplan et al Pediatrics 2011; 127(3):427-435. o Example: Patient on the urology ward of Hospital A had the central line removed and is discharged home a few hours later. Results: In all eight hospitals, the CLABSI rate is not statistically different than the NHSN rate. The Authority’s analysis of CLABSI events from Pennsylvania hospitals (all unit types), as reported to NHSN from July 2008 through March 2009, calculated average CLABSI rates of 1. In 2014, the Joint Commission developed an on-line toolkit that outlines evidence-based practices and techniques to assist health care organizations prevent and sustain a zero standard for CLABSI’s. of Eligible Acute/CAH/ Children’s Hospital Reporting Data . 56"60 : a. 2,3 Patients in ICUs are at an increased risk for CLABSI because 48 percent of ICU patients have indwelling central venous catheters, accounting for 15 million central line days per year in U. o Example: Patient on the urology ward of Hospital A had the central line removed and is discharged home a few hours later. 1 Monitoring of CLABSI rate correlates with implementation of CLABSI prevention bundle for the years 2010 and 2011 – the centers with monitoring have more bundle components (2010: 32% vs 12%, p=0. 17 2. 89 S Trinitas Regional Medical Center 8 9257 7. 00 0. 2019 CNISP CLABSI SURVEILANCE PROTOCOL Final – 4Revised December 2018 C. Purpose: The purpose of this quality improvement initiative was to reduce the CLABSI rate in the neonatal intensive care unit from 3. populations ranged from $21,400 to $110,800 (2009 dollars). 008 CAUTI 0. S. Central Line Access Eligible Central Line. 82 20. 52 MRSA 0. (John Hopkins, 2018). Curbing this habit represents an improvement. 0. Preventing CLABSI In the NICU ! The Challenges ! Identification of Best Practices ! RCTs available ! Individual practices vs. Number of Observed and Predicted CLABSI Infections by ICU and Ward Type, Jan-Jun 2018 Unit Type Observed Infections Predicted Infections How Does This Facility Compare to the National Experience? Adult/Ped ICUs 1 Less than 1. 9 per 1000 line days in 2011 by at least 50% in 2014. 2 inpatient CLABSI per 1000 central line days in pediatric HCT (mean; 13 The overall CLABSI rate decreased from 11. The economic strain of these infections is estimated to be upwards of $26,000 per case. 12 H Virtua Memorial Hospital of Burlington County 2 8486 6. ENDO, GIT, and IAB have limited inclusion organisms. The patient must meet one of the NHSN site-specific infection definitions (UTI, PNEU, SSI) core_eval_and_add_req_topics. 855. 00 0. In this first of a two-part series, we’ll focus on indications and insertion. State the correct method to identify denominators for data analysis of both event types (CLABSI) are Costly & Prolong Care! Attributable cost per bloodstream infection is estimated to be $3,700 to $29,000. 613 0. 52 MRSA 0. Hospital Inpatient Quality Reporting Program Reporting CLABSI in ICUs in acute-care hospitals through the CDC/NHSN Reporting began in January 2011 for FY 2013 Medicare payment determination January 2015 –CMS expanded CLABSI reporting to medical, The CLABSI bundle tool kit is a collection of supporting documents, resources, and tools to assist hospitals in implementing the bundle. Facilities are grouped by general size (i. The catheter is often used to draw EORRGRUJLYHÁXLGVRUPHGLFDWLRQV It may be left in place for several weeks. hsag. New Jersey Hospital Improvement Innovation Network (NJHIIN) CLABSI Prevention HAI TAP Workshop. 17 2. Your support ID is: 10763827058852836552. If we assume that the mortality associated with a CLABSI is18%, then there will be 2 preventable deaths (13 preventable CLABSIs x 0. • An estimated 131 infections were prevented which translates to an estimated 14 – 41 deaths prevented and over $2. 1 Date of CLABSI event 6 2. Prevention and control of CLABSI depends greatly on awareness and implementation of evidence based procedures. , ICU • Consider using antimicrobial-impregnated catheter If line is expected to be in >5 days tions applied the NHSN CLABSI sur-veillance definition was documented, with each organization varying to dif-fering degrees from the computer algo-rithm in their CLABSI rates. 2 inpatient CLABSI, both per 1000 central line days, which is comparable to the 2011 NHSN report of 2. Third, when a CLABSI occurs, we need to devise methods to successfully treat patients with the catheters in place and thus salvage needed CVCs. If a CLABSI is suspected, the provider will order blood cultures. IMPORTANT! Beginning with 2012 data, facilities must appropriately Report No Events for those ffective in reducing CLABSI rates. This law was reduced reimbursement for reasonably preventable hospital-acquired conditions, including CLABSI. 762 SSI COLON Surgical Site Infection 1. 7. patients die annually due to CLABSIs – Average increased length of stay is 7 days – Estimated cost per CLABSI is $3,700- 29,000 • CLABSI rates in Maryland ICUs are being reported to CLABSI is a laboratory-confirmed bloodstream infection (BSI) in a patient who had a central line within the 48 hour period before the development of the BSI, and that (CLABSI) still occur in intensive care units annually This is an already vulnerable and compromised patient population CLABSI can lead to patient death CLABSI are preventable through application of evidence-based practice When a catheter (tube) is placed in a large vein and not put in correctly or kept clean, it can become a way for germs to enter the body and cause serious infections in the blood (central line-associated bloodstream infections, CLABSI). S. These infections are serious but can often be successfully treated. 613 0. 6 CLABSI per 1000 central line days pre-implementation to 4 per 1000 post-implementation (p < 0. implementation of a comprehensive strategy to reduce rates of CLABSI, the CLABSI rate is not decreasing. Central Line-Associated Bloodstream Infection (CLABSI), Illinois Department of Public Health August, 2019 . 762 SSI COLON Surgical Site Infection 1. Secondary BSI according to NHSN must meet these requirements: a. 1% for patients with a risk score of 0, to 2. Yes, a central line-associated BSI (CLABSI) because the blood and catheter tip cultures grew the same organism. Access = an eligible line for CLABSI events. 3 It is apparent that CLABSI represents not only a serious and ongoing patient safety threat but also a major economic burden for healthcare providers. For the CLABSI in pediatric ICU patients. Number of Events Monitoring compliance with practices aimed at prevention of central-line associated bloodstream infections (CLABSI) is fundamental to improvement. CLABSI central line associated blood stream infection References Patient population Hospital mortality % Attributable CLABSI No CLABSI CLABSI No CLABSI Blot [17] 176 315 27. The term “central line” used in the guidelines is defined as an intravascular access device or catheter that CLABSI rates are expressed as the number of infections per 1000 central-line days. Study flow diagram. May 25 1994;271(20):1598-1601. This is reported to NHSN as a CLABSI for the MICU, because the Emergency Department is not an inpatient location and no denominator data are collected there. Denominator device days: CLABSI WHAT IS A CENTRAL LINEff ASSOCIATED BLOODSTREAM INFECTION? A central line or central catheter is a tube that is placed into a patient s large vein, usually in the neck, chest, arm or groin. Two sets of blood cultures should be drawn with AT LEAST one (and preferably both) from peripheral sites. Since that time, both behavioral and technological inter- tainment for CLABSI (and CAUTI) depends on clinical behaviours. For each case, up to 3 controls were matched (National Healthcare Safety Network [NHSN] birth weight category, chronological age, and central venous catheter (CVC) dwell time at the time of CLABSI onset). 104 CDIFF 0. The worksheet lists best practices related to insertion, care, and maintenance of central lines, as well as best practices associated with leadership, education CLABSI cases that occurred between April 2009 and March 2014 were identified through local infection control databases. 040 0. •Attributable mortality per CDC is 12-25%. 040 0. 3 CLABSI and healthcare-associated infections 6 2. 2 Repeat CLABSI timeframe 6 2. Solution MEDITECH’s EHR Benefits • Lowered SIR to . hospitals each year . ! HAI bloodstream infections prolong hospitalisation by a mean of 7 days. They report 0. These infections are usually serious infections typically causing a prolongation of hospital stay and increased cost and risk of mortality. Reporting of CLABSI data from both pediatric ICUs (PICU) and neonatal ICUs (NICU) commenced in October, 2009. CLABSI PREVENTION Central Line-Associated Bloodstream Infection Risks & Prevention The intent of this document is to highlight practical recommendations in a concise format designed to assist acute care hospitals in implementing and prioritizing their central line-associated bloodstream infection (CLABSI) prevention efforts. 8% 51. 2 Repeat CLABSI timeframe 6 2. com/hiin May 2019 CLABSI. 8% 51. • Chapter 2 “Identifying Healthcare-associated Infections (HAI) for NHSN Surveillance” contains a section called “Pathogen Assignment Guidance” –suggested reading • SUTI, PNEU, and VAE have excluded organisms. Number of Observed and Predicted CLABSI Infections by ICU and Ward Type, Jan-Jun 2018 Unit Type Observed Infections Predicted Infections How Does This Facility Compare to the National Experience? Adult/Ped ICUs 1 Less than 1. Finally, we also need to do a better job reconciling the differences between surveillance definitions and clinical definitions of CLABSI and stop using CLABSI surveillance PDF | Surveillance is an active process which requires proactively reviewing data sources indicative of an infection with the most common starting point | Find, read and cite all the research PDF | Objective Central line associated bloodstream infection (CLABSI) is an important cause of morbidity and mortality in the neonatal intensive care | Find, read and cite all the research you CLABSI. 774 0. CLABSI and Surgical Site Infection (SSI) standard population data is CY 2006–2008. Policies, protocols, team members utilized, competencies, and techniques were created and a formal line-rounding and dressing change competency was established. Number of Observed and Predicted CLABSI Infections by ICU and Ward Type, Jan-Jun 2018 Unit Type Observed Infections Predicted Infections How Does This Facility Compare to the National Experience? Adult/Ped ICUs 1 Less than 1. The project was based […] Study group: 260 patients, 1 CLABSI with an infection rate of 0. Methods: We conducted an observational study of patients with central line catheters at 2 adult tertiary care hospitals in Indianapolis from January 2015 to June 2017. With the objective to test the hypothesis that catheter biofilm microbiome in neonates with CLABSI differs than those without infection, we prospectively enrolled View Clabsi Prevention PPTs online, safely and virus-free! Many are downloadable. 352 0. Central line days: the number of days a central line has been accessed to determine if a LCBI is a CLABSI . e. hsag. • Order sets and reporting on key metrics empower staff to ask the right questions in their central line care efforts. Third, when a CLABSI occurs, we need to devise methods to successfully treat patients with the catheters in place and thus salvage needed CVCs. element used to meet the LCBI criterion occurred • If the date of event for a CLABSI is the day of transfer or discharge, or the next day, the infection is attributed to the transferring location Introduction: Central line associated blood stream infection (CLABSI) is a laboratoryconfirmed bloodstream infection where central line (CL) was in place for more than 2 calendar days on the date of event, with day of device placement being Day 1. c. It is not synonymous with the catheter-related bloodstream infection (CRBSI) definition and is not intended to offer guidance regarding patient care decisions for the patient who has been classified as meeting the definition. However, implementation of CLABSI prevention programs requires individualized strategies for different institutional situations, and the best strategy in resource-limited settings is uncertain. In July, 2005, the Legislature passed and the Governor signed Public Health Law 2819 requiring hospitals to report select HAIs to the New York State Department of Health. of CLABSI is more than $1 billion, the cost per patient is more than $16,000. of Positive (CLABSI) is the most common hospital-acquired infection among pediatric patients resulting in excess mortality, increased hospitalization stay and increased health care costs. ICUs. S. Annual number of deaths associated with HAIs in the U. 89 SSI HYST Surgical Site Infection 1. Used to monitor pressures within the heart, they have similar CLABSI rates as other nontunneled CVCs; however, the subclavian site has a lower risk. 6,7 For example, in the pediatric population, McKee alludes to mainte-nance failures by stating that improving practices for central line insertion leads to a reduction in CLABSI, but not its elimination. 910) L This document is an executive summary of the APSIC Guide for Prevention of Central Line Associated Bloodstream Infections (CLABSI). CLABSI rate monitoring 2010 - 18% of centers 2011 - 21% of centers. 585 0. If the skin is not cleaned properly, pathogens can migrate along the external surface of the catheter from the skin entry site. 54 8. 001 Average BSI Rate for Peripheral and Central Lines (per 1000 patient days) 0. 26 CLABSI rates (at the time of reporting) were lower than both the state (1. Umscheid and colleagues performed a systematic review and reported that costs from studies in general U. This report focuses on trends in NHSN CLABSI aggregate data from acute care and critical access hospitals from 2009 – 2016. Health care workers, patients and families can play an active role in CLABSI prevention. criteria for BSI. 7 Although some mortality studies use slightly different definitions of CLABSI, the studies • Data on the incidence of CLABSI among patients using a CVC for HD access was collected over a period of 2. This data represents reporting of CLABSI in Pediatric and Neonatal ICU from January 1, 2016 to December 31, 2016. CLABSI is a surveillance definition only. 00 0. 4 CLABSIs per 1000 catheter-days. National Comparison‡ The Valley Hospital 7 9164 7. This report will only include in-plan CLABSI data for each adult, pediatric, and neonatal ICU beginning with 2011 data . S. 774 0. 5/1000 central line days (0/1000 central line days from July 2012 to July 2014) during the post Central Line-Associated Bloodstream Infections (CLABSI), 2015 Hospital Name Observed # of CLABSI (O) Number of Central Line Days Expected # of CLABSI ( E )a CLABSI SIRb CLABSI SIR p-value Confidence Interval National Comparison ‡ AtlantiCare Regional Medical Center-City Campus 4 4526 10. 0 No CLABSI rates were reduced from a peak of 3. 352 0. Particularly, we examined changes in device utilization, CLABSI and CAUTI events, the associated microbiology of these infections, and the impact on outcomes reflected by the NHSN standardized infection ratio. b. 145 SMB: Sepsis Management Bundle 62. 93% . 12 Similarly, in Hawaii, a statewide ICU Collaborative focusing on comprehensive CLABSI prevention efforts reduced the mean CLABSI rate from 1. Patient B is eligible for a CLABSI on March 31 (CL Day 3) through April 3. The study found that the rate of CLABSI decreased in all four groups without a statistically significant difference in results. Get ideas for your own presentations. 145 SMB: Sepsis Management Bundle 62. The patient is not eligible again for a CLABSI until April 6, when the second central line Under this initiative, 893 CLABSI harms were prevented and an estimated $15,181,000 was saved. 41 per 1000 line days to 1. 17 1. After insertion, appropriate CVC dressings, careful catheter access technique, alcohol catheter caps and the use of prophylac-tic lock therapy with taurolidine, antibiotic or preservative-containing heparin solution can reduce the risk of infection in some groups. With the creation of a CLABSI task force came a CLABSI and CAUTI outcomes in 78 hospitals of a large multi-state healthcare system in the United States. One method of review is apparent cause analysis. In 2012, 170 central line-associated bloodstream infections occurred among 184,031 central line days in Virginia hospital adult intensive care units (ICUs), yielding a standardized infection ratio (SIR) of 0. Standardized Infection Ratio and 95% Confidence Interval The SIR is a measure that compares the CLABSI burden in adult ICUs at a facility to that of the national referent population (2015 NHSN inpatient data). During this time period, the units implemented maintenance bundles. 377 0. 7 per 1,000 catheter-di4i titdays in 4 inpatient wards Page | 1 Additional resources are available at: www. 1. The CLABSI bundle elements are largely supported by CDC/HICPAC, APIC, SHEA, and IDSA guidance A qualitative observational study conducted by the Leapfrog Group on CLABSI prevention stated that, implementation of best practices such as hand hygiene, maximal sterile barrier precautions, chlorhexidine skin antisepsis, appropriate insertion site selections, and prompt removal of unnecessary catheters proved a marked reduction in the rate of Central venous catheters (CVC) provide necessary access to the bloodstream; however, their use places patients at risk for central-line-associated bloodstream infection (CLABSI). Include the indications for catheter use, appropri­ ate insertion and maintenance, the risk of CLABSI, and general infection prevention strategies. CLABSI R tCLABSI Rates • CLABSI rates outside ICUs may be similarCLABSI rates outside ICUs may be similar to rates of these infections in ICUs • Although data are sparse in one studyAlthough data are sparse, in one study CLABSI rates were: – 57 1000 th t5. This is reported to NHSN as a CLABSI for the MICU, because the Emergency Department is not an inpatient location and no denominator data are collected there. CLABSI Central Line-Associated Bloodstream Infection (CLABSI) Event Introduction: An estimated 248,000 bloodstream infections occur in U. Health care workers, patients and families can play an active role in CLABSI prevention. 8% for patients with a risk score of 5 . 585 0. 1 for ward locations, which is significantly better than the national averages of 2. One source of CLABSI is contamination colonization by microorganisms spreading from the extraluminal surface to the intraluminal surface of the catheter access port. Its multifactorial nature renders it challenging to control. 3% Quality Priority Measures FY19 Target FYTD21 CLABSI quality improvement project in ICU | 1 IVTEAM. 3% Quality Priority Measures FY19 Target FYTD21 HAIs are a significant cause of morbidity and mortality, affecting about 3% of hospital patients on any given day. 4 Recent studies have demonstrated that consistent application • A CLABSI is attributed to the location of the patient on the day of event • Defined as the date that the . Hospital leaders adapted materials that were handed down from the system to fit their institution. 762 SSI COLON Surgical Site Infection 1. This data represents reporting of CLABSI in Adult ICU from January 1, 2016 to December 31, 2016. 2p) Use prophylactic antimicrobial lock solution in patients with long term catheters who have a history of multiple CRBSI despite optimal maximal adherence to aseptic technique. • Patient has a central line inserted on June 1. 040 0. 59 in May 2018. 5 years for treatments performed at all 12 hospitals in the network. 00 1. A central line is a flexible tube that is inserted near the patient’s heart or into one of the large veins or Why is CLABSI Prevention Important? An estimated 30,100 central line-associated bloodstream infections (CLABSI) still occur in intensive care units and wards of U. 6 CLABSI per 1000 central line days pre-implementation to 4 per 1000 post-implementation (p < 0. 89 SSI HYST Surgical Site Infection 1. 104 CDIFF 0. Furuya EY, Dick A, Perencevich EN, et al. b. 17 2. 2 Reporting CLABSI in Oregon • Legislative context – Established by OAR 333-018 • Oregon CLABSI reporting requirement (updated 2015) – All hospitals (acute-care, critical access, long-term acute care) The CLABSI bundle tool kit is a collection of supporting documents, resources, and tools to assist hospitals in implementing the bundle. 992 2. CLABSI-related mortality is assumed to range from 12% to 25% 6 and is the most clinically significant metric at hand, causing immense impact to patients and their families. Nurses are on the frontline of CLABSI prevention, contributing to the 58% decrease in CLABSI rates that has occurred between 2001 and 2009 (CDC, 2016). 70; P=. On June 3, the central line is removed and on June 4 the patient has a positive blood culture with . One method of review is apparent cause analysis. Central Line-Associated Bloodstream Infection (CLABSI) Statewide Consumer Report Reportable Period: January 1, 2018 - December 31, 2018 . (See Specimen collection: Best practices. Despite their involvement in the process, they CLABSI 1. 80 CLABSI per 1000 catheter-days. 551 from 2016-17 and the national industry standard of 1. Adult Medical Cardiac Intensive Care Unit . 2 October, 2008. 7. 1 (2018) and 0. Curr Infect Dis Rep (2015) 17: 35 DOI 10. 001). In this proposed study, the practice guidelines will set the limit of using the PICC line and the timing of removal CLABSI, and released the first recommended bundle to the network. CLABSI is the term used by the US Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) 9 (see NHSN CLABSI information). 12 34. pdf Chopra V, Shojania K. 0 Reduction Goals. NHSN Surveillance Case Studies Rachel Cathey, MPH, CIC Healthcare-Associated Infections Epidemiologist April 25, 2019 Central Line-Associated Bloodstream Infections 2 Classification of CLABSI 6 2. 0/1,000 central line The CLABSI audit protocol was developed by the VDH HAI Team by reviewing recent protocols used by other states that have conducted similar CLABSI validation projects in conjunction with input from the Virginia chapter of the Association for Professionals in Infection Control and Epidemiology (APIC-VA), the Virginia Hospital & Healthcare This is a CLABSI because the central line was in place for >2 calendar days on the date of event. c. 1,2,3 More than a decade ago, the bundles were shown to reduce rates of central venous catheter (CVC)–related infections. • A single omission of scrubbing the hub prior to access permits bacterial entry, attachment and biofilm formation that allow the bacteria to strengthen prior to release into the bloodstream. 15% chlorhexidine gluconate – 70% strategy to reduce rates of CLABSI, the CLABSI rate is not decreasing. What to do when a CLABSI occurs. , one was successful, one less so). 12 The research CLABSI rate, a strategy found in Category 1 of the CDC (O’Grady et al. , <200 licensed beds, 201-500 licensed beds, and >501 licensed beds). A CLABSI is a primary bloodstream infection (that is, there is no apparent infection at another site) that develops in a patient with a central line in place within the 48-hour Bundles incorporate evidence-based science into practices, and bundle use is recommended in central line–associated bloodstream infection (CLABSI) guidelines. 52 MRSA 0. Recipes for checklists and bundles: one part active ingredient, two parts measurement. Evidence based clinical practice guidelines have recommended multiple strategies to reduce CLABSI rate. 613 0. Central Line-Associated Bloodstream Infection (CLABSI) Agent: Bacteria, virus, or fungus Mode of transmission: A CLABSI is a central line-associated bloodstream infection. acute care facilities each year. Appropriately preparing the insertion site can dramatically CLABSI? • Central lines are common – 48% of ICU patients • CLABSIs are associated with bad outcomes – 500-4,000 U. With over 40,000 CLABSIs per year in the US, the impact on the healthcare system is significant. similar types of patients, and have similar risk of CLABSI based on published U. CLABSI 0. Insertion 2. element used to meet the LCBI criterion occurred • If the date of event for a CLABSI is the day of transfer or discharge, or the next day, the infection is attributed to the transferring location Please enable JavaScript to view the page content. CLABSI FACTS An estimated 41,000 central line-associated bloodstream infections (CLABSI) occur in U. 001). 008 CAUTI 0. The network strategy has been successful with a 11% CLABSI reduction across the network as of May 2014. No preventable CLABSIs occurred in June through August 2018. 04 S University Hospital 36 15403 16. 585 0. Yes, a CLABSI because the blood cultures are positive for a pathogen (E. S. Objective • We sought to identify best demonstrated practices for the elimination of hospital-acquired CLABSI among patients receiving HD in the inpatient setting. 4 Non-inpatient healthcare-associated infections 6 3 Applying the CLABSI definition for surveillance 7 3. NHSN Surveillance Case Studies Rachel Cathey, MPH, CIC Healthcare-Associated Infections Epidemiologist April 25, 2019 Central Line-Associated Bloodstream Infections size, rural vs. pdf > HIIN Evaluation Measures • CLABSI standardized infection ratio (SIR) (NQF 0139) reported for > ICU units, including NICU > ICU and other units • Central line utilization ratio (central line days/10,000 patient days) • CLABSI rates (CLABSIs per 1,000 central line days, CLABSIs per 10,000 patient days tion (CLABSI). Decrease the rate of CLABSI by 40% in all tracked units by September 23, 2016. and inpatient data, and the use of current CLABSI nomenclature, although this study combined pediatric HCT and oncology patients. Learn from Defects 5. 3 CLABSI and other HAIs, however, are largely preventable. hospitals each year. Numerators Central lineONLY-associated BSIs related to an ICU admission are to be reported. CENTRAL LINE-ASSOCIATED BLOODSTREAM INFECTIONS (CLABSI) Ms Mary Mwinga 2. 3 CLABSI and healthcare-associated infections 6 2. 17 1. Maintenance a. 12 The introduction of a maintenance bundle prior to creation of the line team did not reduce CLABSI rates, yet application of that same bundle by the maintenance team led to significantly improved Fortunately, CLABSI prevention developed into a national initiative. 30 S Central line-associated bloodstream infection (CLABSI) Diagnosis If there is more than minimal erythema or ANY purulence at the exit site, the catheter is likely infected. 84 26. This is a CLABSI because the central line was in place for >2 calendar days (June 1 Central Line Catheter-Associated Blood Stream Infection (CLABSI) rate for ICU patients NQF#: 0139 Developer: Centers for Disease Control and Prevention Data Source: Leapfrog Hospital Survey Secondary Data Source: CMS Hospital Compare Description: Rate of CLABSIs acquired during the ICU stay. 714 1. CLABSI, central line–associated bloodstream infection. Excess mortality has been estimated at 0. 774 0. 1. 13 This habit produces numerous false positive results. Ensure you have chlorhexidine in your central line kits 4. Process and outcome measures can be used to determine the existence and extent of barriers to safe care and the effectiveness of improvement strategies. Learn new and interesting things. 8% 51. 040 0. CLABSI is a term used only for surveillance purposes to identify BSIs that occur in the population at risk (patients with central lines) by the US Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN) (see from CLABSI are 12% to 25% and significantly increase cost and hospital length of stay (Centers for Disease Control and Prevention [CDC], 2011). S. The ICP from Hospital B calls the next day to Central Line Associated Blood Stream Infection (CLABSI) Prevention In 2010, ANZICS and the Australian Commission on Safety and Quality in Health Care (ACSQHC) led a project to decrease Australian ICU CLABSI to <1/1000 line days and to facilitate accurate and consistent CLABSI measurement, with timely reporting to clinicians and benchmarking opportunities. 616 1. While nearly all of the participating hospitals had made notable improvements in CLABSI rates postintervention, some hospitals had virtually eliminated CLABSIs and maintained those results for 6 months or longer. Pre Intervention (1/15 - 6/15) Intervention (11/15 - 5/16) 4/7/2016 4 . 1 Interpreting Criterion 1 and Criterion 2 8 3. eligible central line. This document is a summary of the CLABSI prevention guidelines developed by the Asia Pacific Society of Infec-tion Control (APSIC). Central line infections are important because they are the most common bloodstream infections and can harm patients. 44 Hajjej [25] 32 120 21. S. , 2010). The purpose of this study was to If your CLABSI rate is 5. 040 0. Methods for the diagnosis of acute fever for a patient suspected of having short-term central venous catheter infection or arterial catheter The theme throughout the research articles on CLABSI prevention is the importance of an informed health care practitioner. In 2009 it was estimated that about 23,000 CLABSI in the inpatient setting in the United States would increase mortality and morbidity for patients (CLABSI) costs vary. Central line bundle implementation in US intensive care units and impact on bloodstream infections. 0 No Background Central line-associated bloodstream infections (CLABSIs) can be prevented through well-coordinated, multifaceted programs. Central Line-Associated Bloodstream Infection (CLABSI) Case Patient received CHG bath/shower in 48 hours prior to CLABSI (ICU and 14K) Yes No N/A (CLABSI) among patients in intensive care units (ICUs), neonatal ICUs (NICUs), and medical, surgical, and medical/surgical wards. 87 13. 00 1. 8% 51. 3% Quality Priority Measures FY19 Target FYTD21 View CLABSI QI PROJECT NURS 152. 4 Non-inpatient healthcare-associated infections 6 3 Applying the CLABSI definition for surveillance 7 3. com/hiin May 2019 prevent CLABSI. Particularly, we examined changes in device utilization, CLABSI and CAUTI events, the associated microbiology of these infections, and the impact on outcomes reflected by the NHSN standardized infection ratio. The CLABSI rate is calculated per 1,000 central line-days by dividing the number of CLABSIs by the number of central line-days and multiplying the result by 1,000. It is believed that a large proportion of these are associated with the presence of a central vascular catheter, though this is an area where more study is needed. A bloodstream infection can occur when indication for reducing CLABSI for short term non-tunneled catheters unless the facility is demonstrating success at preventing CLABSI with baseline prevention practices. 011). 52 MRSA 0. S. 88 to 0. Untitled. Two sets of blood cultures should be drawn with AT LEAST one (and preferably both) from peripheral sites. CLABSI prevention (quality of evidence II). L indicates hospital infections are LOWER than infections seen nationally. 613 0. Many IPs are unaware of the rule that secondary bloodstream infections must be assigned to an infection meeting an NHSN definition. 5 Total 553 100 A Central Line Associated Blood Stream Infection (CLABSI) is a laboratory-confirmed bloodstream infection in a patient where the central line was in place for > 2 calendar days (48 hours)* on the date of the event, with day of device placement being Day 1. 72. ” Success has been reflected in the prevention of 25,000 CLABSIs over the last decade, translating to a 58% reduction in infections, with 6000 deaths prevented and $414 million saved. 45 22. Additionally, partnering with the hospital epidemiologist or an infection control practitioner can help your CUSP team-- 1. Bloodstream Infection (CLABSI)? Laboratory-confirmed primary bloodstream infections that are not secondary to another infection and that occur in Intensive Care Unit (ICU) or Neonatal Intensive Care Unit (NICU) patients in whom a central line or umbilical catheter was in place at the time of, or within 48 hours before, onset of the infection. In 2013, Phase II hospitals (n=55) joined the network and the number of children harmed per month increased to 159. d. A comprehensive CLABSI prevention program includes unit-based root cause analysis of each infection and programs to promote, monitor and sustain evidence (CLABSI) Road Map MHA’s road maps provide hospitals and health systems with evidence-based recommendations and standards for the development of topic-specific prevention and quality improvement programs, and are intended to align process improvements with outcome data. Bathe ICU patients over 2 months of age with a chlorhexidine preparation on a daily basis. The ICP from Hospital B calls the next day to CLABSI cases caused by MRSA resulted in even higher associated costs to hospitals ($58 614 [95% CI, $16 760-$174 755]). Identify Defects (Staff Safety Assessment) 3. 616 1. 104 CDIFF 0. Page | 1 Additional resources are available at: www. Central line: also called central venous access device -Is a long, thin, flexible tube used to give medicines, fluids, nutrients, or blood products over a long period of time, usually several CLABSI Case Studies. CLABSI are also considered reasonably Line-associated Bloodstream Infection (CLABSI) 2. Educate on the Science of Safety 2. 043 at baseline to 0. The Rochester CLABSI Collaborative •Project funded by NYSDOH since 2008 •Focus on CLABSI surveillance and prevention outside the ICU •6 hospitals- 37 units •Education of nurses on line care maintenance QualityNet Home PLABSI Infection Rate CLABSI Infection Rate* p<0. urban, academic vs. 00 1. aureus. 17 1. ) CLABSI prevention strategies fall into three cate-gories: clinical indications, insertion, and care and maintenance. (CLABSI) will result in better patient outcomes and a reduction in health care costs. These infections are serious but can often be successfully treated. State the Centers for Disease Control and Prevention’s definitions and criteria of Surgical Site Infection (SSI) 3. hospitalized and critically ill, determining the risk of CLABSI posed by PICCs relative to other CVCs is important for both cost and patient safety. 5 infections per 1000 catheter days to 0. The Toolkit for Reducing Central Line-Associated Blood Stream Infections (CLABSI) can help your unit implement evidence-based practices to reduce and, in many cases, eliminate CLABSI. (At Methodist Hospitals, the analysis is facilitated by a mem-ber of the infection prevention team who’s a clinical nurse specialist with expertise in critical care and is cer- CLABSI defined. 18) per I f ti (CLABSI) i NInfections (CLABSI) in Non-It i CIntensive Care Unit (non-ICU) Settings Toolkit Activity C: ELC Prevention Collaboratives Alex Kallen, MD, MPH and Priti Patel, MD, MPH Division of Healthcare Qualit y Promotion Draft - 1/22555/09 --- Disclaimer: The findin gs and conclusions in this presentation are those of the authors CLABSI (O) Number of Central Line Days Expected # of CLABSI ( E ) a. Handle and maintain central lines appropriately. 24 (rate ratio=0. 257, well below previous year’s rate of 1. (Rutkoff, 2014) CLABSI CLABSI in the PICU (Miller et al 2010) Results In October – December of 2008 (Q2FY09), the PICU CLABSI rate was higher than the National Healthcare Safety Network Clinical Implications As a hospital goal for FY 2012, interventions aimed at decreasing CLABSIs should be aimed at sustaining CLABSI in the PICU (Miller et al. 6 infections per 1000 catheter days 16-18 months post-intervention. Policies, protocols, team members utilized, competencies, and techniques were created and a formal line-rounding and dressing change competency was established. hospitals by implementing a Comprehensive Unit-based Safety Program (CUSP), which was an evidence- based interventions and a patient safety model. Despite this, CLABSI remains a significant cause of mortality and morbidity in patients who have a central line in situ worldwide. • Education surrounding CLABSI Purpose:The purpose of this quality improvement initiative was to reduce the CLABSI rate in the neonatal intensive care unit from 3. Central line-associated bloodstream infections (CLABSI) are among the most lethal and financially costly compared to other hospital associated infections (HAI). 1 Date of CLABSI event 6 2. Another participated in the Keystone project. | 1 Abstract: Background: Nosocomial infection is a significant burden on healthcare facilities. 613 0. Central Line-Associated Bloodstream Infections (CLABSI) Table 4. 00 0. 89 SSI HYST Surgical Site Infection 1. 6082 0. If ports were better disinfected before and after They funded a national efort to prevent CLABSI in U. 9 Other gram-negative rods 29 5. Biofilm formation is universal on indwelling catheters but why some biofilms seed the bloodstream to cause CLABSI is not clearly understood. clabsi. In July, 2005, the Legislature passed and the Governor signed Public Health Law 2819 requiring hospitals to report select HAIs to the New York State Department of Health. 7 and 23. Main outcome measures: CLABSI rate (cases per 1000 central line days). Smith was admitted to CCU after having a heart attack. 037 and 2011: 36% vs 15%, p=0. 352 0. CLABSI Prevention Special Approaches If CLABSI rates high or have not decreased to established goals despite consistent use of core practices • Perform daily chlorhexidine bathing (2% solution) in select populations, e. 0 days, respectively). The following reports from 2008-2011 present the number and rate of infections for central line-associated bloodstream infection (CLABSI) data for each facility required to report by regulation. Thus, skin pathogens are a common cause of CLABSI, especially within the first seven days of CVC insertion. 1007/s11908-015-0491-8 SEPSIS AND ICU (L NAPOLITANO, SECTION EDITOR) Eliminating Infections in the ICU: CLABSI Asad Latif 1 & Muhammad Sohail Halim 2 & Peter J. 12 The introduction of a maintenance bundle prior to creation of the line team did not reduce CLABSI rates, yet application of that same bundle by the maintenance team led to significantly improved A central line bloodstream infection (CLABSI) occurs when bacteria or other germs enter the patient’s central line and then enter into their bloodstream. HAIs are a significant cause of morbidity and mortality, affecting about 3% of hospital patients on any given day. 0262 (0. 2013; 22(2): 93-6. Comply with hand hygiene requirements. Central line-associated bloodstream infection (CLABSI) Diagnosis If there is more than minimal erythema or ANY purulence at the exit site, the catheter is likely infected. The following QRPs include CLABSI. Nurses are on the frontline of CLABSI prevention, contributing to the 58% decrease in CLABSI rates that has occurred between 2001 and 2009 . 2. Additionally, quantifying this risk will CUSP & CLABSI Interventions 1. 104 CDIFF 0. 2–5 Acquiring CLABSI is associated with prolonged usage of central lines and increased ICU and hospital length of stay, ultimately costing more than (CLABSI) are risks to patient safety, increasing morbidity, mortality, length of stay and cost of medical care. AHRQ is currently expanding this effort to the cific region in implementing CLABSI prevention efforts. Yet, reducing the frequency of cultures will reduce CLABSI and CAUTI (CLABSI) CLABSI are primary bloodstream infections in patients that had a central line in place within 48 hours before the development of the infection. •CLABSIs contribute to increased morbidity, length of stay and cost. 2 Other pathogens 36 6. While the attributable mortality associated with these infections is likely quite low, the economic costs and morbidity can be substantial. 76 infections per 1,000 central line days to 1. Ensure you are using National Healthcare Safety Network definitions for CLABSI11,12 2. 145 SMB: Sepsis Management Bundle 62. 9 per 1000 line days in 2011 by at least 50% in 2014. CLABSI SIR. During insertion, use a sterile sleeve on this catheter to reduce infection risk. HEN 2. 145 SMB: Sepsis Management Bundle 62. More than 1,000 intensive care units across the country reduced CLABSI rates by 41 percent when their clinical teams used the tools in this toolkit along with the CLABSI Location Attribution • A CLABSI is attributed to the location of the patient on the day of event – Defined as the date that the . 9 Target Threshold Jan-15 Feb-15 Mar-15 Apr-15 May-15 Jun-15 Jul-15 Aug-15 Sep-15 Oct-15 Nov-15 Dec-15 Jan-16 CLABSI rates on your unit. There is also considerable pressure from unit directors to reassign CLABSI. • The comprehensive strategy should include at least the following three components: educating persons who insert and maintain catheters, use of maximal sterile barrier precautions, and a >0. 82 21. Standardized Infection Ratio (SIR) Escherichia coli 16 2. CDI and MRSA standard population data is CY 2010–2011. 008 CAUTI 0. 762 SSI COLON Surgical Site Infection 1. We provide weekly feedback of CLABSI data to all units along with their “Weeks Since Last CLABSI” data. 2 Timing (application of the 48 hour rule) 8 Uncovering the cause of the CLABSI and developing an action plan are key steps to preventing future infections. Percentage of ICU patients, who over a certain amount ‡ Each hospital is compared to the National Ratio=1 which is derived using the CDC's NHSN data from 2006-2008 for CLABSI (AJIC, December 2009). Similarly, both CLABSI and SSI cases caused by MRSA resulted in the highest attributable excess LOS (15. 585 0. Two terms, centralline–associated bloodstream infection (CLABSI) and catheter-related bloodstream infection (CRBSI), should be distinguished in the following way4,5: CLABSI is the term used by the US Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network (NHSN)6 (see NHSN CLABSI 2 • CID 2009:49 (1 July) • Mermel et al. hospitals each year and a large portion of these are associated with the presence of a central vascular catheter. •Some peer hospitals have achieved lower CLABSI rates through standardization of care, prompt removal of lines, attention to culturing practices and CLABSI is still a major problem facing health care workers worldwide, especially among cancer neutropenic patients. CLABSI 0. It describes key evidence-based care components of the Central Line Insertion and Maintenance Bundles and its implementation using the quality improvement methodology, namely the Plan-Do-Study-Act (PDSA) methodology involving multidisciplinary process and patient factors individual (staff) factors work/ environmental factors task factors team factors organizational and management factors care delivery reduction of HAIs. PLoS One. 07 central line-days per 100 patient-days. S. CLABSI Prevention Resources: Surveillance Data •Unit Specific Data is sent out monthly by Epidemiology, includes: •CLABSI Rates •CLABSI SIR •CLIP Compliance •Unit specific data is also available on unit dashboards. Infect Control Hosp Epidemiol 1999 Jun;20(6):396-401. Standardized Infection Ratio and 95% Confidence Interval The SIR is a measure that compares the CLABSI burden in pediatric and neonatal ICUs at a facility to that of the national referent population Some initiatives have been able to achieve rates of zero CLABSI for prolonged periods of time. pdf. 3% Quality Priority Measures FY19 Target FYTD21 surveillance and feedback of CLABSI rates. 81 Cheewinmethasiri [8] 44 129 20. Finally, we also need to do a better job reconciling the differences between surveillance definitions and clinical definitions of CLABSI and stop using CLABSI surveillance CLABSI : THINGS TO REMEMBER • A secondary BSI does not set a RIT. community) but had contrasting outcomes for CLABSI reduction (i. 613 0. 56 21. 2/1000 central line days in quarter 4, 2008) during the pre‐intervention period to 0. 3 NHSN locations are also combined to provide a more robust statistical assessment of Washington State hospitals. 008 CAUTI 0. • Create an interdisciplinary CLABSI reduction team, including nursing and physician unit or department champions. 2 Timing (application of the 48 hour rule) 8 Central Line-associated Bloodstream Infection (CLABSI) What is a CLABSI? CLABSI is a primary laboratory confirmed bloodstream infection in a patient with a central line at the time of (or within 48-hours prior to) the onset of symptoms and the infection is not related to an infection from another site. 1. bundles of practices ! Implementation ! How best to introduce effective catheter insertion and care Central Line-associated Bloodstream Infection (CLABSI) What is a CLABSI? CLABSI is a primary laboratory confirmed bloodstream infection in a patient with a central line at the time of (or within 48-hours prior to) the onset of symptoms and the infection is not related to an infection from another site. 65 ambulatory CLABSI and 2. Share yours for free! . 17 1. 2/1000 central line days (peak of 5. • 2/2: A central line was placed in the cath lab. 1 The two phases, insertion and maintenance, of CVC life and associated CLABSI prevention strategies may challenge infection preventionists when assigning resources to CLABSI and CAUTI outcomes in 78 hospitals of a large multi-state healthcare system in the United States. As a result of their safety program hospitals reduced CLABSI in the first 18 months by 66 percent. 616 1. 6 *Because CLABSI bundle was implemented prior to study, no significant change to CLABSI rate was anticipated or observed during study time period. Other locations/earlier years for which you may have reported CLABSI data will not be included in this output. Over the study period, the unadjusted CLABSI rate was low and decreased from 0. criteria for BSI. Bundle for the prevention of catheter-associated urinary tract infections (CAUTI) CAUTI is defined as a urinary tract infection (significant bacteriuria plus symptoms and/or signs attributable to the urinary tract with no other identifiable source) in a patient with current urinary tract catheterization or significant reductions in CLABSI. 0% to 11. Results: The average CLABSI rate fell from 2. Percentage of Reporting Units with CLABSI Rate of 0/1,000 or Less than 1/1,000 CL On the CUSP: Stop BSI is estimated to have saved an estimated 290 to 605 deaths assuming a 12-25 percent CLABSI mortality rate and an estimated $97,777,123 to $244,318,277 in excess costs averted to date, figures that are projected to continue to increase over time. faecalis), there is no evidence of infection at another site, and the patient had a central line in place. If a CLABSI is suspected, the provider will order blood cultures. 3/1000 x 2500. (At Methodist Hospitals, the analysis is facilitated by a mem-ber of the infection prevention team who’s a clinical nurse specialist with expertise in critical care and is cer- CLABSI is associated with significant morbidity, mortality, and costs. Clinical indications An often overlooked first step in CLABSI prevention is asking whether a central line is clinically indicated. 0 No Conclusion Adult/Ped Wards 0 Less than 1. clabsi pdf