Other Healthcare Associated Infections Measures



Improvement Stories

Preventing Central Line Infections: Improving Care and Reducing Costs

Central Line Associated Bloodstream Infections

What are we measuring and why?

Healthcare associated infections (HAI) are infections that patients acquire while receiving medical treatment in a healthcare facility. These infections are often harmful and costly to treat, but can usually be prevented through the use of proper precautions and infection control practices. The Centers for Medicare and Medicaid Services (CMS) publishes hospital HAI results, which are increasingly used to assess the quality and safety of patient care. Data are reported as a standardized infection ratio (SIR), which compares a hospital’s observed number of infections to its predicted number of infections, after adjusting for institutional characteristics known to cause differences in incidence. A lower SIR is better, with the ultimate goal of zero infections.

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

Central Line Associated Blood Stream Infections (CLABSI) are associated with insertion, maintenance, or prolonged usage of a central line – a narrow tube inserted into a patient’s vein to collect blood for testing or deliver important medications/fluids. When not placed correctly or kept clean, bacteria and other germs can travel through the central line and enter the patient’s bloodstream. To reduce the risk of infection, it is important for clinicians to remove the line as soon as it is no longer medically necessary, as well as maintain the cleanliness of the line and insertion site while it is in place.

Publicly reported CLABSI rates include adult and pediatric medical, surgical, and combined medical/surgical units and all intensive care units. In 2017, MGH’s CLABSI SIR (0.69) was statistically better than the national benchmark (1.0).

  • Current Scores
  • Scores Over Time
  • Lower values are better
0.82 0.69

MGH Source: National Healthcare Safety Network
Comparison Group Source: CMS Hospital Compare

MGH: Jan - Dec 2017
CMS: Jan - Dec 2017

1.06 1.03 0.69 1.01 0.9 0.82

MGH Source: National Healthcare Safety Network
Comparison Group Source: CMS Hospital Compare



What are we doing to improve?

MGH has ongoing efforts aimed at reducing the rate of preventable CLABSIs. This includes observing best practice techniques outlined by the Centers for Disease Control and Prevention (CDC), such as proper hand hygiene, cleansing of the patient’s skin before line placement, using full barrier precautions during insertion, and early line removal. In addition, we bathe patients in the ICU with chlorhexidine on a daily basis and use special chlorhexidine sponge dressings on all central lines to reduce the risk of infection.

 

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