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Infection control nurse led to zero CLABSIs, decreased costs in surgical ICU
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The addition of an infection control nurse in a 19-bed surgical intensive care unit reduced catheter-associated bloodstream infections to zero and saved more than $200,000 during a 6-month period, according to data presented during a telebriefing in advance of the 38th Annual Educational Conference and International Meeting of the Association for Professionals in Infection Control and Epidemiology.
“We had a catheter-associated bloodstream infections (CLABSIs) rate that was significantly higher than the national average, and this had been a sustained problem over a long period of time,” Michael Anne Preas, RN, BSN, CIC, infection preventionist at the University of Maryland Medical Center, said during the telebriefing.
“They had many best practices in place, they used the standardized central-line cart for all the placement of their catheters; sterile barrier precautions when inserting lines; a checklist; impregnated sponges; and used antiseptic-coated catheters whenever possible. The staff believed that they could not get to zero, they felt their patients were too sick and they were doing everything they could, but this was the best it was going to be.”
From July to December 2010, Preas and colleagues initiated a project to reduce CLABSIs and improve infection control in a 19-bed surgical ICU. Infection control nurses (ICNs) were appointed to monitor and assist with all central-line insertions, stop breaks in sterile technique, coordinate the necessity of each catheter on daily rounds, and to perform daily assessment of central-line dressings to ensure they were dry and intact.
A no-tolerance rule was enforced for any breach in hand hygiene compliance or isolation; the ICN taught daily educational sessions to discuss best practices for CLABSI prevention.
“Almost immediately, we began to see no CLABSIs,” Preas said. During a 25-week time frame, the ICU sustained a zero CLABSI rate. The retrospective analysis revealed that 14 CLABSIs were eliminated and two to three lives were saved vs. the previous year.
“The estimated cost of one CLABSI is approximately $18,000, and by avoiding 14 CLABSIs during this time frame, they avoided nearly $260,000 in costs,” Preas said. “We calculated the cost of a nurse for a 6-month time frame of $44,000, which led to a net savings of more than $200,000. One infection control preventionist can make an impact, but can’t make a difference the way the work of the unit can by changing their own internal culture.” – by Ashley DeNyse
For more information:
- Preas MA. #1616. Association for Professionals in Infection Control and Epidemiology’s (APIC) 38th Annual Educational Conference and International Meeting; June 27-29, 2011; Baltimore.
I find the abstract very exciting; it validates what infectious disease physicians have been preaching for decades. Many infections can be prevented by strict adherence to established infection control guidelines. The problem has been lack of resources being made available by the administration. The often used reason has been that the economic impact could not be demonstrated to justify the expense. This study demonstrates that tremendous patient impact, as well as financial, can be accomplished. Hopefully, this study can be duplicated to add support to the practices utilized. Providing the personnel and authority to enforce the protocol can save lives and money.
R. Brooks Gainer, MD
Infectious Disease News Editorial Board member
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