CLABSI Rounding Team

Abstract

Background: Central line-associated bloodstream infections (CLABSIs) are an ongoing concern in health care, resulting in increased mortality, morbidity, length of stay, and additional costs to hospitals. Local Problem: Despite intermittent improvements in CLABSI rates within our facility, long-term sustainment has been challenging. Methods: This was a quality improvement project including a collaborative rounding approach supported by specialty nursing roles. Interventions: In addition to implementing a variety of evidence-based interventions, the rounding team performed audits to assess performance and created focused education tools to address the identified opportunities within each individual unit. Results: High levels of engagement as evidenced by increased audit completion resulted in CLABSI reductions. However, 2 peaks in CLABSI rates were associated with higher volumes of coronavirus disease (COVID-19) hospitalizations and decreased audits. Conclusions: Despite challenges correlated with COVID-19, a collaborative rounding team promotes and enhances awareness of prevention methods and a culture of safety.

Investigating potential drivers of increased central line...associated bloodstream infections during the coronavirus disease 2019 (COVID-19) Omicron surge

“…Our study aligns with other studies that identified increased central line utilization, 6 decreased central line audits, 7 increased traveling nurses, 8 and increased patient acuity 6 as potential drivers of CLABSI during the COVID-19 pandemic. Our study is notable as we are, to our knowledge, the first to describe potential drivers during the Omicron surge when the severity of COVID-19 was less and vaccines were widely available, but local staffing was the most constrained.…”

“…Central line-associated bloodstream infection (CLABSI) rates increased during the coronavirus disease 2019 (COVID-19) pandemic in the United States. 1 , 2 Previous work attributes high volumes of COVID-19 positive inpatients, 3 , 4 , 5 increased central line utilization, 5 , 6 critical illness, 6 decreased volumes of infection prevention practice audits, 7 staffing shortages leading to use of traveling nurses, 8 and supply chain problems 9 as potentially contributing to this increase. At our rural academic medical center, the increase in CLABSI was most notable during the winter of 2021 during the Omicron surge when we cared for the highest number of COVID-19 positive patients.…”

Coronavirus disease 2019 (COVID-19) impact on central-line-associated bloodstream infections (CLABSI): a systematic review

“…However, the authors did not assess if such high compliance was associated with reduced CLABSI rates, representing a major limitation of the study and preventing any interpretation of their findings. Nevertheless, other authors have shown that lower compliance is generally linked to higher infection rates [ 36 ] and the Israeli paper also highlights an interesting factor: the prevention of CLABSI in Israel is incentivized, including monetary compensation from the Department of Health, potentially contributing to the increased compliance with IPC measures.…”

“… Increase Pate et al. , 2022 [ 36 ] Presence of central line CLABSI rates Number of audits completed USA Quality improvement project with audit tool and feedback 874-bed, level 1 trauma and academic medical center in Charlotte (NC) High levels of audit completion resulted in CLABSI reductions However, two peaks in CLABSI rates were associated with higher volumes of COVID hospitalization and decreased audits Increase Audit tool consisted of 10 different components (see text for further information) Patel PR et al. , 2022 [ 12 ] COVID-19 CLABSI rates USA Retrospective data analysis National Healthcare Safety Network (NHSN) database (nearly all US hospitals) A 28% increase was observed in the national standardized infection ratios (SIRs) and 45% CLABSI increase in the Upper Northeast region Increase ∗ Preliminary data presented.…”

“…The importance of compliance with IPC practices and its relation with CLABSI rates has also been highlighted in a study conducted in an academic medical center in North Carolina [ 36 ]. Compliance with an audit tool with ten different components (type of line, chlorhexidine disk compliance, cleanliness of needleless connectors, presence of alcohol caps, compliance with labelling of tubing, presence of blocked lines, completion of a daily antimicrobial bath, and daily assessment of line necessity) resulted in a CLABSI decline.…”