Assessing Central Line Utilization in the Journey to Decrease CLABSI Rates in an Academic Tertiary Care Facility

ISSUE: Central Line Associated Blood Stream Infection (CLABSI) has become a focus of health care professionals, regulatory agencies, payers, and the public over the past few years. Our hospital has spent the last 3 years working with our teams to create a culture of safety around insertion and maintenance of central lines, resulting in a reduction in CLABSI rates. However, as we have not reached our goal of zero, we decided to take a closer look at our line utilization. There are data to support an increased risk of CLABSI associated with central line utilization and duration of line placement. PROJECT: A prospective 30 day audit of all central line prevalence was conducted on our adult inpatient units. A daily central line report generated by electronic medical record and a review of documentation were used to obtain patient name, medical record number, unit, date of admission, date of line insertion, type of line, and current patient/line disposition. Line duration was calculated for each patient who had a central line during this time period. The same report was used to calculate central line days per unit and a patient census report provided by the billing department was used to calculate central line utilization rates for comparison to the 2010 National Healthcare Safety Network (N.H.S.N.) benchmarks. RESULTS: Our tertiary academic facility consists of 5 adult intensive care units (ICU’s), 3 ICU step-down units, and 7 floor status medical, surgical, and specialty units. Of the 15 total units, only 2 of our floor status medical/surgical units were above the N.H.S.N. pooled mean for device utilization. Data regarding utilization by device type, duration and patient acuity are listed in tables below.