Prevention of Central Line associated Bloodstream Infections

- Indicators for Monitoring

To ensure the appropriate prevention of catheter associated blood stream infection in hospitals and reduce the risk of CLABSI, specific indicators should be monitored regularly. These are some indicators which can provide measurable data to assess compliance, identify areas for improvement, and guide interventions. Here are some key indicators that can be included in hospital guidelines for prevention of CLABSI.

a) CLABSI Prevention Process Measures

1. Documentation of daily assessment regarding patient’s need for continuing CVC access

Calculate the % of patients who received daily assessment for continuing need for CVC access

● Numerator: Number of CVC insertions with documentation of daily assessment

● Denominator: number of patients with CVC

● Standardization factor: 100 (i.e., multiply by 100 so that measure is expressed as a percentage)

b)   Outcome Measures:

1. Rates of CLABSI (Number of CLABSI per 1000 device-days)

Measurement of rates allows an individual facility to gauge the longitudinal impact of implementation of prevention strategies:

● Numerator: Number of central line-associated bloodstream infections (BSIs) identified for the patient care unit(s) under surveillance

● Denominator: Number of central line-days for the patient care units under surveillance

● Standardization factor: Multiply by 1000 so that the measure is expressed as cases per 1000 device-days.

2. Device Utilization Ratio (DUR): The catheter utilization ratio is the number of central line-days per number of patient-days in a given period. This is a measure of the total patient-days in which a central line was used and can be used as a marker for risk of infection.

● Numerator: total of central line-days for the location(s) under surveillance for the specified time period.

● Denominator: the total number of days that patients are in the location during the selected time period.

According to the approved CDC criteria,

*Device days are the total number of days of exposure to urinary catheter for all the patients during the selected time period.

*Patient days are the total number of days patients are in the ICU during the selected time period

1.1 Plan to Update this National Clinical Guideline

This guideline will be reviewed and updated when new evidence emerges that is likely to influence the recommendations.