Association of CLABSI With Hospital Length of Stay, Readmission Rates, and Mortality: A Retrospective Review

Abstract

BackgroundAn evidence‐based practice (EBP) approach to implementing change is relevant and pertinent to the strategy to improve outcomes for hospitalized patients with central venous catheters (CVC). As health systems endeavor to achieve the ambitious goals of improving the patient experience of care, improving the health of populations, and reducing the cost of health care, it is imperative to understand the impact of a central line‐associated bloodstream infection (CLABSI) on outcomes.AimsThe purpose of the study was to contribute to the evidence of the association of CLABSI with the outcomes of hospital length of stay (LOS), readmission rates, and mortality rates for hospitalized patients.MethodsA retrospective study was conducted, including all hospitalized patients with a CVC within four hospitals in an integrated health system in northwest Ohio and southeast Michigan. The sample population was stratified into two groups, CLABSI and no CLABSI, and the outcomes of interest for each group were compared.ResultsThe findings substantiate the association between CLABSI and the hospital mortality rate, LOS, and readmission. Patients with a CVC who develop a CLABSI were 36.6% more likely to die in the hospital and 37.0% more likely to be readmitted compared with patients with a CVC who did not develop a CLABSI. In addition, hospital LOS increased an average of 2 days compared with patients without CLABSI. This study evokes implications for EBP change to reduce the rate of CLABSI and for quality improvement during in‐hospital care.Linking Evidence to ActionThere is an association between CLABSI and hospital mortality rate, LOS, and 30‐day readmission outcomes, presenting a profound sense of urgency for EBP change. There were potential variances in processes or practice relative to insertion, maintenance, and removal in the hospitals studied, representing an opportunity to examine the best practices in the hospitals that are performing well. Implementation of EBP requires selecting effective and innovative strategies, with a focus on stakeholder involvement and needs.

Nurses' experiences and perspectives regarding evidence‐based practice implementation in healthcare context: A qualitative study

“…It also improves the standard of healthcare services and cost management in the framework of the healthcare system, lowering the risk of medical error and patient mortality (Dang et al, 2021). Furthermore, EBP encourages professional development and lowers diversity in clinical practices, thus decreasing mortality and fostering patient satisfaction (Chovanec et al, 2021).…”

Vascular Access Team Central Line Dressing Changes to Reduce Infection Risk

“…The risk of infection increases the longer the CVAD is in place 1. According to the 2024 Infusion Nurses Society (INS) Infusion Therapy Standards of Practice (the Standards ), a central line-associated bloodstream infection (CLABSI) is defined as “a primary bloodstream infection in a patient who had a CVAD the day of or day before infection and had more than 2 days of central access.”2 In the National Healthcare Safety Network definition, it is stated a CLABSI is “a laboratory confirmed primary bloodstream infection that is not secondary to an infection at another body site, urinary tract infection, pneumonia, and surgical site infection.”1 A CLABSI may present in a patient in an intensive care unit (ICU) or non-ICU setting and is associated with an increased hospital length of stay, readmission, and antibiotic use 3-7. A single CLABSI can cost the hospital between $40,412 and $100,980, with an average cost of $70,696 8.…”

Clinical epidemiology and a novel predicting nomogram of central line associated bloodstream infection in burn patients

“…Catheter-related infection (CRI) and thrombosis are the two major, sometimes lethal, complications of CVCs, with central line-associated bloodstream infection (CLABSI) being the most serious presentation, and characterised by a significantly higher incidencetwo-to three-foldin burn patients (15.5-29.1 per 1,000 catheter days) than in other patients (4.80-8.64 per 1,000 catheter days) [8][9][10][11].…”

“…CLABSI not only prolongs the patient's hospital stay and increases the medical burden [8] but also may affect clinical outcomes and increase morbidity and mortality [9,10]. It has become one of the key indicators of nosocomial infections worldwide, with serious complications ranging from sepsis syndromes, endocarditis, and haematogenous transmission, which leads to additional healthcare, estimated in one study to be increased over two-fold [11].…”