There are several measures one can take to decrease the incidence of CLABSI, and the introduction of the first widely adopted set of guidelines for the prevention of CLABSI in 2002 has led to a substantial reduction in the incidence of CLABSI.
Other studies have estimated CLABSIs account for a range between 84,000-204,000 infections per year, resulting in up to 25,000 preventable deaths at a cost of up to 21 billion dollars per year. Although there has been a 46% reduction in CLABSI rates in the United States between 20, an estimates 30,100 CLABSIs still occur in intensive care units and acute care wards each year. However, it is important to understand the differences between the two definitions ( Table 1).ĬLABSIs are an important cause of morbidity and mortality in the intensive care unit, and lead to increased costs to the healthcare system. Since CLABSI is the more commonly used definition for quality initiatives, it will be the focus of this chapter. the NHSN definition) applied inconsistently could be exploited or be prone to subconscious cognitive bias to lower infection rates. These public policy changes and financial incentives to produce low CLABSI rates have raised concerns that partially subjective surveillance definitions (e.g. In addition, since many states now require public reporting of hospital CLABSI rates and the Centers for Medicare and Medicaid Services instituted financial penalties for hospital reimbursements for CLABSI, there is more granularity in the reviews of bloodstream infections in some institutions, and efforts are now made to thoroughly investigate the possibility of secondary sources that, in years past, may not have occurred. However, in the years since the CDC instituted mucosal barrier injury as a category for secondary sources of bacteremia this overestimation has been reduced. The CLABSI definition has the potential to overestimate the true incidence of CRBSI, since many primary bloodstream infections do not have an obvious secondary source. In contrast, the diagnosis of CLABSI is a simplified definition based on surveillance criteria that identify bloodstream infections in patients with CVCs in which there is no other obvious secondary source for bacteremia. This definition is more often used for research, and in some cases of clinical care, since it requires specialized microbiological techniques to specifically identify the catheter as the source of bacteremia that may not be available in all hospitals. CRBSI is a clinical definition based on clinical criteria related to a specific patient in which the diagnosis is being considered. There are two major definitions used to describe bloodstream infections related to CVCs: catheter-related bloodstream infection (CRBSI) and central line-associated bloodstream infection (CLABSI).
0 kommentar(er)
