CLABSI Prevention at Home Starts With Sharing Patient Information

The patient with home infusion therapy has an improved outcome when home health care agencies and acute care facilities communicate relevant information on their shared patients.

A new study called, “A Task Analysis of Central Line-Associated Bloodstream Infection Surveillance and Home Infusion Therapy” was recently published in the American Journal of Infection Control (AJIC) that highlighted major barriers affecting health care workers’ ability to perform successful central line-associated bloodstream infection (CLABSI) surveillance among patients receiving home infusion therapy. The study was funded by the Agency for Healthcare Research and Quality (AHRQ), and it describes facilitators, strategies, and suggestions for improving CLABSI surveillance, both in the home and health care facilities to better track and monitor infection rates.

“Although we focus a lot on certainly CLABSI prevention and acute care hospitals, patients do go frequently go home, with central lines in place for things like central parenteral nutrition, chemotherapy, long term antibiotics, allotropes, and indications,” said Sara C. Keller, MD, MSHP, MPH, associate professor at Johns Hopkins University School of Medicine, Armstrong Institute of Patient Safety and Quality, and lead author on the published study in an exclusive interview with Infection Control Today^®. “Some patients can have these central lines in place for years, most frequently with support from home infusion therapy agencies.”

The investigators to see what practices and as well as barriers and strategies there are for home infusion therapy agencies trying to monitor for CLABSI.” To do this, the investigators interviewed staff members at five different home infusion agencies covering portions of 14 states across the country.

They began by figuring out what the home infusion agencies’ steps were for CLABSI surveillance. The major steps included first learning who to monitor for CLABSI which was much more difficult for many of the home health agencies’ staff than the investigators expected, according to Keller. The second step was to identify the need to investigate each individual patient who may have a complication and symptoms of CLABSI. The third step is gathering information on those patients who potentially might have a CLABSI, then, fourth, determining whether the patients have had a biopsy, and then fifth, summarizing and examining all their data on each of the patients. The sixth step is sharing this data with stakeholders. Next is seven, identifying an action plan, and then the eighth and final step is taking action to prevent future CLABSI.

Keller also discussed how communication is the key to many issues in health care in this exclusive interview with ICT^®.