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Few hospitals reported CLABSI rates lower than national average for inpatient wards
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Among 10 hospitals, only two inpatient wards had rates of central line–associated bloodstream infections less than the pooled rate identified in a 2009 report by the National Healthcare Safety Network, recent data indicate.
Researchers from Memorial Sloan-Kettering Cancer Center and other US universities conducted an electronic survey of 10 tertiary care hospitals to determine infection surveillance practices and central line–associated bloodstream infection (CLABSI) rates in non-ICU inpatient wards. The survey, sent in March 2011, included 12 questions about demographics and CLABSI surveillance methods.
To derive the numerator, six of the 10 hospitals obtained daily reports and four had hospital physician epidemiologists review charts as needed or on a regular basis. To derive the denominator, five hospitals counted patients with a central line daily. Other hospitals estimated using electronic orders for maintenance or from another automated method.
The total annual central venous catheter days ranged from 6,965 to 57,487 days. CLABSI rates ranged from 0.2 to 4.2 infections per 1,000 catheter-days. The 2009 National Healthcare Safety Network reported CLABSI rates of 1.14 infections per 1,000 catheter-days. Device utilization ratios ranged from 0.12 to 0.42 in non-ICU inpatient wards. The median non-ICU device utilization ratio was 0.24. The National Healthcare Safety Network reported a pooled device ratio of 0.15 for non-ICU patient wards.
“Recognizing the complexities of non-ICU CLABSI surveillance is important not only because it affects surveillance methodology, but also because it may affect decisions on how to allocate valuable infection prevention resources,” the researchers wrote. “We suggest that additional data and study are necessary before hospitals can begin to understand the quality of their programs.”
Disclosure: The researchers report no relevant financial disclosures.
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