Central Line Associated Bloodstream Infection (CLABSI) Prevention
The Central Line Associated Bloodstream Infection (CLABSI) Prevention Advanced Application is aimed at hospital infection prevention teams, clinical and operational directors, hospital leadership and members of quality improvement teams. The CLABSI application enables users to efficiently find, review, and document CLABSI cases to support NHSN (National Healthcare Safety Network) reporting and to review outcomes and trends of CLABSI across institutions and health systems. It also provides near real-time analysis of internal processes related to CLABSI to support care process improvement for CLABSI prevention.
- The Performance dashboard helps users measure the outcome metrics (CLABSI rate, central line utilization, excess cost, etc.) in relation to the intervention metrics (hand hygiene and central line maintenance bundle compliance).
- The Central Line Risk dashboard enables users to identify the hospital care location where patients are at increased risk of developing CLABSI.
- The Workflow dashboard(s) provide infection prevention surveillance teams with automated work lists. These dashboards are interactive and give the surveillance team the ability to evaluate cases flagged as at-risk, along with supporting clinical details, to make the final determination of the CLABSI case prior NHSN submission.
Specific capabilities powered by the app include the ability for users to:
- Rapidly find, assess, and document CLABSI cases according to NHSN definitions.
- Efficiently review NHSN submission data and CLABSI rates.
- Easily identify trends in performance and CLABSI prevention bundle compliance.
- Understand CLABSI risk based on device utilization and bundle compliance a care location to identify and prioritize improvement interventions.
- Drill down to the facility, unit, service, or patient level to analyze performance, provide feedback, and support measurement of performance improvement interventions.
- Hospital billing records
- Professional billing system(s)
- Nurse charting
Infectious complications from central line placement, known as CLABSI (central line-associated bloodstream infections), are alarmingly frequent with over 30,000 cases annually reported by acute care hospitals. CLABSI cases are largely preventable by proper application of best practices for central line insertion and maintenance bundles.
What types of problems do CLABSI Prevention address?
In FY 2015, the CMS-administered Hospital-Acquired Conditions (HAC) Reduction Program will penalize the lowest performing hospitals by 1 % based on CLABSI rates, CAUTI rates reported to the NHSN (National Healthcare Safety Network), and PSI-scores. This has made identifying and reporting CLABSI cases even more important for health systems. However, doing so often requires extensive manual chart review according to complex NHSN rules. This inefficient surveillance process results in ‘measurement waste’–one consequence of which is a lack of infection prevention resources available to support upstream clinical process improvement to actually decrease the risk and incidence of reported CLABSI cases.
- An executive is interested is understanding the hospital CLABSI rate as well as understanding how compliant the doctors and nurses are at following best practices for hand hygiene. The CLABSI advanced application allows this user to find these outcome and intervention metrics.
- An infection preventionist (IP) would like to easily identify and review all positive blood cultures to determine if additional CLABSI cases need to be reported to the CDC via NHSN. The CLABSI advanced application allows the IP to filter down a list of positive blood cultures to those most recently collected and flagged as “pending review.” The IP can then quickly evaluate and confirm or rule out potential CLABSI cases.
- Increased compliance with practices shown to decrease CLABSI: best practice device utilization, central line insertion practices, and maintenance bundle use.
- Decrease CLABSI rate and decrease central line days.
- Revelation of system-wide variation in CLABSI rates and variation in internal processes related to CLABSI (e.g., compliance with best practice central line insertion and maintenance bundles).
- More efficient and reliable NHSN reporting.
- Ability for Infection Prevention resources to be redirected to analysis, feedback, and intervention to improve CLABSI prevention process and outcomes.
- Increased insight into trends, populations, practice and performance—increased ability to uncover the “why” behind CLABSI and the “where” to focus improvement efforts.
Success Measure Examples
There are 3 types of success measures: Opportunity Identification:
- Measure and broadly share CLABSI rates and CLABSI prevention bundle compliance measures across the enterprise to help make visible the opportunities for improvement.
- XX% improvement in reduction of utilization in central line days.
- Decrease CLABSI rate or CLABSI-specific readmission rate by XX%.
- CLABSI is one of the HACs measured for the 1% reimbursement penalty form CMS in 2015.