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Bloodstream Infections: I Believe in Zero CLABSIs! – Part 1 of 2

Posted on by CDC's Safe Healthcare Blog
Cathryn Louise Murphy, RN, PhD, CIC
Cathryn Louise Murphy, RN, PhD, CIC

Guest AuthorCathryn Louise Murphy, RN, PhD, CIC
2010 President – Association for Professionals in Infection Control & Epidemiology
Managing Director – Infection Control Plus
Associate Professor – Faculty of Health Services and Medicine, Bond University

“I believe in zero CLABSIs!” shouted a group of 3,400 APIC Annual Conference attendees at the conclusion of patient-safety leader Dr. Peter Pronovost’s opening session on Monday, July 11. Is the idea of zero central-line associated bloodstream infections a far-fetched dream, or a vision that can become reality for healthcare institutions around the world in the not-so-distant future?

In a new and exciting campaign, APIC has teamed with Dr. Peter Pronovost to mobilize infection preventionists to prove that prevention is possible.

Catheter-related bloodstream infections (CRBSIs) and central-line associated bloodstream infections (CLABSIs) carry high mortality and high cost, leading to more than 30,000 deaths in the U.S. each year and driving up the cost of care by more than $30,000 per patient. This is an even greater problem in developing countries, where the rates of HAIs related to devices are in most cases 3 to 5 times greater than in developed countries.

To discover why these infections remain an issue in healthcare facilities, APIC conducted a survey of 2,000 infection preventionists and released results during the conference. Half of those surveyed agree that catheter-related bloodstream infections continue to be a problem in their facilities and cite lack of time, resources, and the commitment of hospital leadership as hindering their ability to combat these infections more aggressively.

When asked to identify the greatest challenges to implementing best practices to prevent CRBSIs, the top answers were enforcing policies related to infection prevention and educating staff, followed by conducting surveillance using a paper-based system.

While there is increasing awareness among hospital leaders that CRBSIs are an issue, only one in four respondents strongly believe that their facility monitors compliance with best practices for the prevention of CRBSIs or holds clinical staff accountable for adhering to these practices.

Almost all bloodstream infections from catheters are preventable with clear, actionable steps. However, despite the widely publicized success of adopting those steps, only a quarter of U.S. hospitals report having adopted and consistently applying these principles.

We can do better than that. We must do better than that. We believe in zero CLABSIs. With focused efforts and relevant resources, we can eliminate this infection. Entirely.

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6 comments on “Bloodstream Infections: I Believe in Zero CLABSIs! – Part 1 of 2”

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    Couldn’t agree with you more. We can avoid thousands of deaths and and billions of dollars in added costs to our health care system if we can take control and prevent CLABSIs. And I do believe it is really possible to eliminate this infection totally. Let us all do our part and support this program to help end CLABSIs.

    orthopedic specialist

    Our hospital is looking to batch blood work to reduce the manipulation of central lines due to blood draws. Does anyone have any literature to support that this practice will be helpful in reducing blood stream infections.

    Thank you,
    Patricia

    I am the INFECTION CONTROL Liaison for or 35 bed pediatric Pulmonary/Gen Med unit, which often seems and feels like a step down unit. Our challenge seems to be active toddlers who have both central lines and ostomy bags, and ventilators. Please share any tips/hints that have help reduced HA-BSIs in your institution with similiar situations.

    I, too, believe strongly that central line catheter bloodstream infections can be 100% eliminated with proper sterilizing of the equipment, and proper washing of hands by the staff. It takes a good, sound education program for the staff, effective and easy to follow hospital regulations, and a good record keeping system all working together. I think the record keeping part is another role for Health IT to play. Automated record keeping of the sterilizing and inspecting of the equipment, done in real time, and by who is important for making sure critical sterialization and cleaning procedures are followed and for ensuring accountability for carrying out the regulations. Best wishes, Michael E. Bailey.

    Can you point me to prospective studies showing “Almost all bloodstream infections from catheters are preventable”? Also, it seems illogical to lump catheter-related & catheter-associated bloodstream infections together as the latter is a best guess whereas the former reflects a strong association albeit with varying criteria and the possibility that the catheter could have been seeded from another as yet undiscovered site. This matters because compliance is likely influenced by the degree of belief. It is interesting that similar arguments are made for antibiotics within an hour of surgery despite the fact that virtually every study since the original retrospective one from which the guideline was derived has failed to demonstrate benefit.

    My wife are foster parents. We took in an infant who had trisomy 18. She lived to the point where she needed an operation for her to continue living as she had grown to the point where it became medically necessary 54 lbs. We took here in for the operation. The operation was never performed because of a blood infection. Had we been notified sooner we could have had the expertise of a childhood friend who had worked for the Center for Disease Control. Alas it was too late. It still haunts us that we brought her to the hospital because she struggled so much to live and we thought very deserving of this opportunity. You begin to think that maybe this was deliberate malice on someones part. Simple Hygiene. that’s my 2 cents

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