Central Line Associated

Bloodstream Infections
(CLABSI)
Nurs 362
Lisa Chee
Melanie Goo
Grace Kim
Chelsey Miyake
Amber Suzuki

Problem
Estimated 41,000 CLABSI occur each year in
US hospitals
Leads to:
-

increase morbidity
increase mortality
increase cost (hospital & patient)
longer hospital stays

Statistics
1 in every 25 hospital patients suffer from at least one healthcare
acquired infection on any given day (CDC, 2014).
CLABSIs have a high mortality rate of 12%-25% (Whited & Lowe, 2013).
250,000 cases of bloodstream infections each year in the U.S, and
CLABSIs account for 14% of all HAIs (Boubekri, 2013).
CLABSIs contribute to additional hospital costs of more than
$36,000 per infection (Whited & Lowe, 2013).

Indicators- HI vs National
CLABSI in ICU (Jan 2012 to December 2012)

Green circle= The number of infections was lower

(better) than predicted
Yellow square = The number of infections was similar
(not significantly different) than predicted
Red square= The number of infections was higher
(worse) than predicted

Risk Factors

Length of catheter insertion

Multiple CVCs
Multi-lumen catheters
Femoral vein insertion site
Co-morbidities
Catheter care practices
Age - children/neonates & older adults

Cause and Effect Diagram

Risk Factors:
Comorbidities
Age

Improper
catheter care
practices

CLABSI
Catheter insertion
(Catheter Size,
multi-lumen
catheters,
insertion site)

Intraluminal or
extraluminal
contamination

Interventions

Remove unnecessary central lines

Avoid femoral vein
Hand hygiene
Skin antisepsis w/ chlorhexidine
Proper central line insertion & maintenance
(Asepsis)
Use of implantable ports

Intervention Diagram
Risk Factors:
Comorbidities
Age

Improper catheter
care practices

Skin antisepsis
CHG, daily
inspection,
alcohol scrub

Hand
hygiene

Remove
unnecessary
central lines

CLABSI

Catheter insertion
(Catheter Size, multilumen catheters,
insertion site)

Avoid femoral
vein, skin
antisepsis
chlorhexidine
gluconate (CHG),
implantable ports

Intraluminal or
extraluminal
contamination

Recommendations
Preventing CLABSI- CDC checklist for
Clinicians and Facilities
http://www.cdc.gov/HAI/pdfs/bsi/checklist-for-CLABSI.pdf

Insertion bundle
Post-insertion care bundle
In-service for nursing staff
Competence evaluations

Evaluation
Bundles/Checklists to monitor compliance
National Healthcare Safety Network
(NHSN)

Summary
Goal: ID effective interventions to prevent
CLABSIs
Measure Improvement: Decrease in CLABSI
rates
Changes: Implementation of bundles, following
CDC recommendations

Boubekri, A. (2013). Reducing Central Line-Associated Bloodstream Infections in the Blood and Marrow Transplantation
Population: A Review of the Literature. Clinical Journal of Oncology Nursing, 17(3), 297-302. doi:10.1188/13.CJON.297-302
Centers for Disease Control. 2014. Central line-associated bloodstream infection (CLABSI) event. retrieved from http://www.
cdc.gov/nhsn/pdfs/pscmanual/4psc_clabscurrent.pdf
Guerin, K., Wagner, J., Rains, K., & Bessesen, M. (2010). Reduction in central line-associated bloodstream infections by
implementation of a postinsertion care bundle. American Journal Of Infection Control, 38(6), 430-433. doi:10.1016/j.ajic.
2010.03.007
Hawaii State Department of Health (2013). Healthcare associated infections in Hawaii. Retrieved from http://health.hawaii.
gov/docd/files/2014/07/Hawaii-2013-HAI-Report-Final2.pdf.
"The Joint Commission." CLABSI Toolkit and Monograph. N.p., n.d. Web. 12 Oct. 2014. <http://www.jointcommission.
org/topics/clabsi_toolkit.aspx>.
Zingg, W., Cartier, V., Inan, C., Touveneau, S., Theriault, M., Gayet-Ageron, A., & ... Walder, B. (2014). Hospital-wide
multidisciplinary, multimodal intervention programme to reduce central venous catheter-associated bloodstream infection. Plos
One, 9(4), e93898. doi:10.1371/journal.pone.0093898

References