Other Healthcare Associated Infections Measures



Improvement Stories

Preventing Central Line Infections: Saving Lives and Dollars

Central-Line Associated Bloodstream Infections in the ICU

What are we measuring and why?

MGH tracks the number of infections developed by patients in the ICU because of central-line devices. MGH looks at the rate of infection by the number of line days (number of patients in a day with at least one central line).

For patients in the ICU, a central-line is often necessary so the patient can receive fluids and medication. Sometimes patients can develop bloodstream infections associated with these lines. This is called a "central-line associated bloodstream infection" and it can be a serious complication.

How are we doing and how do we compare to best practice?

MGH tracks central-line associated infection rates for the different ICUs at the hospital and we compare our performance to national rates published by the National Healthcare Safety Network (NHSN).

MGH provides care in different types of ICUs, and we report data on care delivered in those ICUs. Semi-annual information is available in the table below for all ICUs combined.

  Rate Comparator Number of
Infections
Line Days
Jan-Jun 11 1.23   1.7   15   12212  
Jul-Dec 11 1.52   1.7   20   13135  
Jan-Jun 12 1.29   1.4   18   13946  
Jul-Dec 12 1.44   1.4   21   14552  
Jan-Jun 13 1.53   1.4   23   15046  
Jul-Dec 13 1.47   1.4   21   14283  
Jan-Jun 14 1.19   1.4   17   14234  
Jul-Dec 14 1.27   1.4   18   14207  
Jan-Jun 15 1.14   1.1   16   14022  
Jul-Dec 15 1.10   1.1   18   13587  

Source for data: MGH Infection Control
MGH ICUs: Burn ICU, Coronary Care ICU, Cardiac Surgery ICU, Medical ICU, Neuro ICU, Neonatal ICU,
Pediatric ICU, and Surgical ICU

What are we doing to improve?

MGH has ongoing efforts aimed at preventing all preventable central-line associated infections. Efforts include monitoring best practice techniques outlined by the Center for Disease Control (CDC) such as hand hygiene, using full barrier precautions during the insertion of the central line, cleaning of the skin with chlorhexidine before inserting a central line, avoiding placing lines in legs if possible, and early line removal.  In addition we are also bathing patients in the ICU with chlorhexidine on a daily basis and we are using a special chlorhexidine sponge dressing on all central lines.

What can you do?

Patients should be encouraged to ask their care team to take the required precautions to reduce the risk of infection during insertion of any central line.  Similarly it is important to have the line removed as soon as it is no longer necessary and to ensure that best practices are used to maintain the cleanliness of the line and insertion site while it is in use.  Patients and family members should be encouraged to ask about the necessity of the central lines and if it is still necessary; patients and families should be proactive and ask for them to be removed as soon as possible.

Click here for a patient friendly information sheet on preventing central line infections.

 

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