The last decade of evolution in the efforts to reduce healthcare-acquired infections (HAIs) has seen a multitude of new initiatives and requirements that address, among other issues, the elimination of central line-associated bloodstream infections (CLABSIs). Organizations such as the Institute for Healthcare Improvement (IHI),1 the Centers for Disease Control and Prevention (CDC)2 and the Joint Commission (JC) all have set standards or outlined specific recommendations that bundle scientifically-supported interventions aimed at reducing CLABSIs in critical care units in United States hospitals. Currently, more than 3,000 hospitals across the U.S. have responded to a call-to-action from the IHI and implemented extensive programs that involve continuous team-centered approaches to aseptic practice during insertion and care of intravascular central lines.
The Joint Commission (JC)’s proposed expansion of its National Patient Safety Goals for 2010 will require hospitals to extend prevention efforts to patients with central lines on non-critical care units.3 Considering that a key CLABSI prevention intervention addresses the need for daily review of catheter necessity, this new JC requirement makes it imperative that novel strategies be considered for patients that may no longer require a multi-port central line but still need extended intravascular access. Such alternate approaches should include the use of an intravascular catheter that offers increased patient safety by reducing the risk of infection.
The heightened emphasis on eliminating CLABSI stems from some very sobering statistics. Although extensive inroads have been made in the prevention of healthcare-acquired bloodstream infection, recent estimates indicate that approximately 250,000 CLABSIs still occur in hospitals. 4 Of these, more than 80,000 occur in intensive care units with 30,000 patients dying as a result of acquiring such infections. The cost to the healthcare system is staggering: an average of $45,000 per infection with a total cost to U.S. hospitals of $2.3 billion.5 The Centers for Medicare & Medicaid has since Oct. 1, 2008 instituted new reforms in which reimbursement for hospital-acquired CLABSI will not qualify for higher payment rates.6 With shrinking third-party dollars and in light of the recent national debate on control of healthcare costs, the issue of infection control becomes imperative.
