Eliminating central line-associated bloodstream infections: A national patient safety imperative

Sean Berenholtz, Lisa Lubomski, Kristina Weeks, Christine A. Goeschel, Jill A Marsteller, Julius Cuong Pham, Melinda D. Sawyer, David Thompson, Bradford D Winters, Sara Cosgrove, Ting Yang, Thomas Louis, Barbara Meyer Lucas, Christine T. George, Sam R. Watson, Mariana I. Albert-Lesher, Justin R St Andre, John R. Combes, Deborah Bohr, Stephen C. HinesJames B. Battles, Peter J. Pronovost

Research output: Contribution to journalArticle

Abstract

background. Several studies demonstrating that central line-associated bloodstream infections (CLABSIs) are preventable prompted a national initiative to reduce the incidence of these infections. methods. We conducted a collaborative cohort study to evaluate the impact of the national "On the CUSP: Stop BSI" program on CLABSI rates among participating adult intensive care units (ICUs). The program goal was to achieve a unit-level mean CLABSI rate of less than 1 case per 1,000 catheter-days using standardized definitions from the National Healthcare Safety Network. Multilevel Poisson regression modeling compared infection rates before, during, and up to 18 months after the intervention was implemented. results. A total of 1,071 ICUs from 44 states, the District of Columbia, and Puerto Rico, reporting 27,153 ICU-months and 4,454,324 catheter-days of data, were included in the analysis. The overall mean CLABSI rate significantly decreased from 1.96 cases per 1,000 catheterdays at baseline to 1.15 at 16-18 months after implementation. CLABSI rates decreased during all observation periods compared with baseline, with adjusted incidence rate ratios steadily decreasing to 0.57 (95% confidence intervals, 0.50-0.65) at 16-18 months after implementation. conclusion. Coincident with the implementation of the national "On the CUSP: Stop BSI" program was a significant and sustained decrease in CLABSIs among a large and diverse cohort of ICUs, demonstrating an overall 43% decrease and suggesting the majority of ICUs in the United States can achieve additional reductions in CLABSI rates.

Original languageEnglish (US)
Pages (from-to)56-62
Number of pages7
JournalInfection Control and Hospital Epidemiology
Volume35
Issue number1
DOIs
StatePublished - Jan 2014

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Patient Safety
Infection
Intensive Care Units
Catheters
Puerto Rico
Incidence
Cohort Studies
Observation
Confidence Intervals
Delivery of Health Care
Safety

ASJC Scopus subject areas

  • Microbiology (medical)
  • Epidemiology
  • Infectious Diseases

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Eliminating central line-associated bloodstream infections : A national patient safety imperative. / Berenholtz, Sean; Lubomski, Lisa; Weeks, Kristina; Goeschel, Christine A.; Marsteller, Jill A; Pham, Julius Cuong; Sawyer, Melinda D.; Thompson, David; Winters, Bradford D; Cosgrove, Sara; Yang, Ting; Louis, Thomas; Lucas, Barbara Meyer; George, Christine T.; Watson, Sam R.; Albert-Lesher, Mariana I.; Andre, Justin R St; Combes, John R.; Bohr, Deborah; Hines, Stephen C.; Battles, James B.; Pronovost, Peter J.

In: Infection Control and Hospital Epidemiology, Vol. 35, No. 1, 01.2014, p. 56-62.

Research output: Contribution to journalArticle

Berenholtz, S, Lubomski, L, Weeks, K, Goeschel, CA, Marsteller, JA, Pham, JC, Sawyer, MD, Thompson, D, Winters, BD, Cosgrove, S, Yang, T, Louis, T, Lucas, BM, George, CT, Watson, SR, Albert-Lesher, MI, Andre, JRS, Combes, JR, Bohr, D, Hines, SC, Battles, JB & Pronovost, PJ 2014, 'Eliminating central line-associated bloodstream infections: A national patient safety imperative', Infection Control and Hospital Epidemiology, vol. 35, no. 1, pp. 56-62. https://doi.org/10.1086/674384
Berenholtz, Sean ; Lubomski, Lisa ; Weeks, Kristina ; Goeschel, Christine A. ; Marsteller, Jill A ; Pham, Julius Cuong ; Sawyer, Melinda D. ; Thompson, David ; Winters, Bradford D ; Cosgrove, Sara ; Yang, Ting ; Louis, Thomas ; Lucas, Barbara Meyer ; George, Christine T. ; Watson, Sam R. ; Albert-Lesher, Mariana I. ; Andre, Justin R St ; Combes, John R. ; Bohr, Deborah ; Hines, Stephen C. ; Battles, James B. ; Pronovost, Peter J. / Eliminating central line-associated bloodstream infections : A national patient safety imperative. In: Infection Control and Hospital Epidemiology. 2014 ; Vol. 35, No. 1. pp. 56-62.
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AU - Berenholtz, Sean

AU - Lubomski, Lisa

AU - Weeks, Kristina

AU - Goeschel, Christine A.

AU - Marsteller, Jill A

AU - Pham, Julius Cuong

AU - Sawyer, Melinda D.

AU - Thompson, David

AU - Winters, Bradford D

AU - Cosgrove, Sara

AU - Yang, Ting

AU - Louis, Thomas

AU - Lucas, Barbara Meyer

AU - George, Christine T.

AU - Watson, Sam R.

AU - Albert-Lesher, Mariana I.

AU - Andre, Justin R St

AU - Combes, John R.

AU - Bohr, Deborah

AU - Hines, Stephen C.

AU - Battles, James B.

AU - Pronovost, Peter J.

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