/ en Sat, 26 Apr 2025 00:07:54 -0500 Wed, 06 Nov 24 15:15:26 -0600 /news/headline/2024-11-06-cdc-report-shows-decreases-certain-health-care-associated-infections-2023 <p>The Centers for Disease Control and Prevention Nov. 6 released its annual <a href="https://www.cdc.gov/healthcare-associated-infections/php/data/progress-report.html">progress report</a> on health care-associated infections, which showed continued decreases in hospitalizations last year. There was a 16% decrease in hospital-onset methicillin-resistant Staphylococcus aureus, or MRSA; a 15% decrease in central line-associated bloodstream infections, or CLABSI; a 13% decrease in hospital-onset Clostridioides difficile (C. difficile) infection; an 11% decrease in catheter-associated urinary tract infections; and a 5% decrease in ventilator-associated events. The declines align more closely with progress made prior to the COVID-19 pandemic in 2020, the CDC said. <br><br>For inpatient rehabilitation facilities, there was a 14% decrease in hospital-onset C. difficile infection and an 8% increase in CAUTI in 2023, but no significant changes in CLABSI and hospital-onset MRSA standardized infection ratios compared with 2022. Among long-term care hospitals, there was a 13% decrease in hospital-onset C. difficile infections but no significant changes in 2023 SIRs compared with 2022. <br><br>The report recommends facilities continue reinforcing prevention practices and review HAI surveillance data to identify areas for improvement.</p> Wed, 06 Nov 2024 15:15:26 -0600 Central Line-Associated Bloodstream Infection (CLABSI) /education-events/case-study-reducing-central-line-associated-bloodstream-infection-clabsi-rates <p><strong>A Case Study in Reducing Central Line-Associated Bloodstream Infection (CLABSI) Rates</strong> <br><em>The Overlooked Patient and Economic Burden of Blood Culture Contamination</em></p><p><strong>Wednesday, February 7, 2024   </strong><br><em>1 - 2 p.m. Eastern; noon - 1 p.m. Central; 10 - 11 a.m. Pacific  </em></p><div class="webreplay"> .webreplay{ border: solid 2px #777; padding: 15px 5px; margin: 0 0 10px 15px; } @media (min-width:360px){ .webreplay{ min-width: 290px; float: right; } } <h2 class="text-align-center"><small>On-demand Webinar</small></h2> MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 3636);</div><p><br>Reducing blood culture contaminations has been proven to support antimicrobial stewardship efforts and optimize patient care quality and outcomes. It has also been shown to decrease the occurrence of false-positive CLABSIs, improving hospital quality reporting and metrics.</p><p>An intervention took place from September 2021 to March 2023 at a Joint Commission-accredited, acute-care hospital serving nine rural counties whereby initial specimen diversion device (ISDD) use augmented all peripheral venipuncture sample collection for adult patient blood culture draws. The objective was two-fold:</p><ul><li>To avoid the unnecessary administration of antimicrobial treatment, which can increase patient morbidity and mortality risk.  </li><li>To reduce the occurrence of false-positive CLABSIs and associated reporting.</li></ul><p>CLABSI reporting and the associated National Healthcare Safety Network (NHSN) standardized infection ratio (SIR) data for the 18-month intervention period was compared to the preceding 18-month period. <br><br>In this webinar, learn how combining evidence-based technique and technology enabled Magnolia Regional Health Center to achieve an 80% reduction in SIR, from 2.6 to 0.5, over the 18-month period, as well as sustained reductions in false-positive CLABSIs hospital-wide.</p><p><br><strong>Attendee Will Learn:</strong>  </p><ul><li>Discuss how false-positive blood cultures can impede hospital antimicrobial stewardship efforts and increase CLABSI rates.</li><li>Illustrate the limitations of standard blood culture practices and review the role of the clinician in blood culture collection.</li><li>Identify solutions that have been proven to reduce false-positive blood cultures, which can lead to CLABSIs and other untoward sequelae.</li></ul><p> </p><p><strong>Speakers:</strong><br> </p><p>Cody G. Stroupe, MD  <br><em>Associate Program Director of IM Residency </em> <br><strong>Magnolia Regional Health Center </strong><br><br>S. Shaefer Spires, MD <br><em>Infectious Disease Physician </em><br><strong>Infectious Disease Consultants of Georgia </strong></p> Tue, 02 Jan 2024 16:04:32 -0600 Central Line-Associated Bloodstream Infection (CLABSI) /education-events/achieving-sustained-reduction-blood-culture-contamination <p><strong>Achieving Sustained Reduction in Blood Culture Contamination</strong> <br /> <em>Deploying technique, technology and process </em></p> <p><strong>Wednesday, September 27, 2023 </strong><br /> <em>1 - 2 p.m. Eastern; noon - 1 p.m. Central; 10 - 11 a.m. Pacific  </em> </p> <div class="webreplay"> .webreplay{ border: solid 2px #777; padding: 15px 5px; margin: 0 0 10px 15px; } @media (min-width:360px){ .webreplay{ min-width: 290px; float: right; } } <h2><small>On-demand Webinar</small></h2>   MktoForms2.loadForm("//sponsors.aha.org", "710-ZLL-651", 3407);</div> <p>Reducing blood culture contamination is critical for accurate diagnosis and effective treatment of bloodstream infections. Contaminated blood cultures can lead to false-positive results, unnecessary treatments, increased health care costs and potential harm to patients. To achieve sustained reduction in blood culture contamination, a multifaceted approach — incorporating technique, technology, and process improvement —has proven to be effective.  </p> <p>One such approach, leveraged by a community hospital affiliated with a large health care system in the East, is the Baldridge Excellence Framework. The Baldridge Framework supported the hospital’s efforts to drive change in organizational behavior for blood culture collection and adoption of evidence-based techniques and technology, the Steripath® Initial Specimen Diversion Device®. Through this combined effort, the hospital exceeded its goal for blood culture contamination rate in just a few short months and continues to deliver consistent performance, month-after-month, below its annual goal.  </p> <p>Join this webinar to learn more about their journey and how the principles of the Baldridge Excellence Framework may be applied to your institution to improve patient safety and quality outcomes.  </p> <p><strong>Attendees Will Learn: </strong></p> <ul> <li>The importance of reducing blood culture contamination for accurate diagnosis and treatment of blood stream infections.  </li> <li>The potential risks and benefits of different techniques and technologies in reducing contamination rates. </li> <li>How to demonstrate a proactive attitude towards contamination reduction efforts through the ALDI Framework.  </li> <li>To evaluate the effectiveness of deployment techniques, technology and process improvement through data analysis and feedback. </li> </ul> <p><br /> <strong>Speaker: </strong></p> <p>Fred Ervin, MHA, RN, BA  <br /> <em>Baldridge Program Manager </em> <br /> <strong>Camden Clark Medical Center </strong></p> Mon, 07 Aug 2023 10:02:04 -0500 Central Line-Associated Bloodstream Infection (CLABSI) /henry-ford-health-accelerating-efforts-reduce-clabsi-rates-yields-promising-results <div class="container"> <div class="row"> <div class="col-md-8"> <div class="row"> <div class="col-md-7"> <p><img alt="Henry Ford Health Case Study. A clinician uses proper technique to insert a patient's central line to avoid Central Line-Associated Bloodstream Infection (CLABSI). " data-entity-type="file" data-entity-uuid="a9a7de6a-057f-4696-9685-362ce81168dc" src="/sites/default/files/inline-images/Henry-Ford-Health-700x500.jpg" width="710" height="500"></p> </div> <p>Patients in the hematology-oncology unit at Henry Ford Health in Detroit commonly need peripherally inserted central catheters, or PICC lines, for chemotherapy, blood transfusions or intravenous nutrition. In 2019, the unit started to see an increase in central line-associated bloodstream infections (CLABSIs).</p> <p>As unit team members examined root causes of the CLABSI rates, they learned there was no standardized process. Patients didn’t understand proper maintenance of their PICC lines or the importance of taking daily baths with chlorhexidine gluconate to decrease the potential spread of bacteria.</p> <p>The unit’s management team went into action by instituting an advanced protocol training program. The <a href="https://www.ahrq.gov/hai/cusp/index.html" target="_blank">Comprehensive Unit-based Safety Program</a> (CUSP), originally developed at Johns Hopkins Hospital, helps clinical teams make care safer by combining improved teamwork, evidence-based clinical best practices and the science of patient safety. The CUSP toolkit gives clinical teams the training resources and tools essential to deploying consistent protocol training and building capacity to improve patient safety.</p> <p>As a result of the advanced training, the process by which PICC lines are ordered, placed and maintained now is clear and consistent. Once an order is put into a patient's chart, the PICC team reviews it and contacts the hematology-oncology unit to schedule an appointment for the patient.</p> <p>The PICC team and unit team are not only better trained to reduce the risk of infections but also to address potential issues before they arise.</p> <p>The outcomes have been remarkable. Henry Ford’s hematology-oncology unit has reduced the incidence of CLABSIs in its hematology-oncology unit by 75%, documenting only two cases between July 2020 and June 2021. The reduction prevented patient harm and also saved an estimated $385,000 in health care costs that would have been incurred to treat the infections. Henry Ford is expanding the new process to other patient care units.</p> <p><em>Henry Ford Hospital's Hematology-Oncology Unit Uses AHRQ Safety Program to Lower Bloodstream Infections. Content last reviewed February 2022. Agency for Healthcare Research and Quality, Rockville, MD. <a href="https://www.ahrq.gov/news/newsroom/case-studies/202202.html" target="_blank">https://www.ahrq.gov/news/newsroom/case-studies/202202.html</a></em></p> </div> </div> <div class="col-md-4"> <div class="CALLOUT"> <h3 class="text-align-center"><span><strong>Key Takeaways</strong></span></h3> <p><small><strong>Targeted Problem</strong>: <strong>CLABSI</strong><br> <span><strong>Interventions Used:</strong> AHRQ’s <a href="https://www.ahrq.gov/hai/cusp/index.html" target="_blank">Comprehensive Unit-based Safety Program</a></span></small></p> <p><small><strong>Impact: </strong> Reduced CLABSI by 75%.</small></p> </div> </div> <p><br> <a class="btn btn-wide btn-primary" data-view-context="top-level-view" href="/infection-prevention-and-control-success-stories">View All Stories</a></p> .CALLOUT { border-left: 3px solid #003087; margin: 0 0 25px; overflow: hidden; padding: 10px; background-color: #f7f8fb; H4: #003087; H5: #003087; } </div> </div> Wed, 26 Jul 2023 15:50:25 -0500 Central Line-Associated Bloodstream Infection (CLABSI) /advancing-health-podcast/2023-07-26-what-clabsi-and-how-prevent-it <p>In the health care field one of the scariest types of infections is called CLABSI, or Central Line-associated Bloodstream Infection. In this episode, Nishant Prasad, M.D., attending physician and program director of infectious diseases at NewYork-Presbyterian Queens, shares how they re-approached CLABSI prevention by deeply examining structure and process, and how their work got them to zero CLABSIs in the last year.</p> <p></p> <div><a href="https://soundcloud.com/advancinghealth" target="_blank" title="Advancing Health">Advancing Health</a> · <a href="https://soundcloud.com/advancinghealth/what-is-a-clabsi-and-how-to-prevent-them" target="_blank" title="What is a CLABSI and How to Prevent It">What is a CLABSI and How to Prevent It</a></div> <hr /> <details class="transcript"><summary> <h2 title="Click here to open/close the transcript."><span>View Transcript</span><br />  </h2> </summary> <p>00;00;01;01 - 00;00;41;29<br /> Tom Haederle<br /> Many of us do a root cause analysis when an adverse event such as the health care associated infection - or HAO - occurs, and we apply interventions to prevent future HAIs from occurring. But what if the interventions still don't work? Today's guest, an attending physician of infectious disease at a Flushing Queens hospital, is here to share how his organization flipped the order of performance improvement tools to achieve desired outcomes.</p> <p>00;00;42;02 - 00;01;12;19<br /> Tom Haederle<br /> Welcome to Advancing Health, a podcast from the ���������� Association. I'm Tom Haederle with AHA Communications. The AHA’s Healthcare Associated Infection Antimicrobial Resistance Project is a funded partnership with the Centers for Disease Control and Prevention. Through the project, the AHA has been listening to the field share its challenges and successes with infection prevention and control. NewYork-Presbyterian Queens in Flushing recently celebrated having no CLABSI’s in more than one year.</p> <p>00;01;12;22 - 00;01;29;20<br /> Tom Haederle<br /> Dr. Nishant Prasad, attending physician and program director of Infectious Diseases, shares how they re approached CLABSI prevention by deeply examining structure and process. He's in conversation with Marie Cleary-Fishman, AHA's vice president of Clinical Quality.</p> <p>00;01;29;23 - 00;01;50;19<br /> Marie Cleary-Fishman<br /> Well, Dr. Prasad, thank you so much for being here today. We really appreciate the time and effort you're putting into this, and we're really interested in learning more about your CLABSI work at your hospital at the NewYork-Presbyterian Queens in Flushing I understand. Could you tell us what that acronym stands for?</p> <p>00;01;50;22 - 00;02;17;00<br /> Dr. Nishant Prasad<br /> Sure. And again, thank you for having me. So a little bit of explanation. Like you said, is a central line associated bloodstream infection. So those invasive catheters that we put into patients to give them medications at the hospital can sometimes be associated with infections that get into the blood from those catheters. So that's what a CLABSI would be considered, when one of those infections occurs.</p> <p>00;02;17;02 - 00;02;28;22<br /> Marie Cleary-Fishman<br /> Thank you for sharing that. And then let's talk a little bit about your focus in 2017 and why you decided to focus on CLABSI. What was your driving force for that?</p> <p>00;02;28;24 - 00;03;13;23<br /> Dr. Nishant Prasad<br /> Yeah, so it actually started well before 2017 because we identified times of events of concern. Prior to that, I would say before 2017, we had set the processes in place to try to address our concern, but we didn't have our initial process as well structured as it should have been. And it's really 2016-ish that we figured out how we should approach our concerns with potential associated bloodstream infections at our hospital.</p> <p>00;03;13;25 - 00;03;22;00<br /> Dr. Nishant Prasad<br /> And once we started utilizing that process is when we really started to see the positive effects.</p> <p>00;03;22;03 - 00;03;41;19<br /> Marie Cleary-Fishman<br /> So just to summarize that a little bit, so would you say that what really made this more successful this time around was that you identified those processes, maybe looking at structure and process to really get to the outcome you were looking for. Was that sort of the crux of the difference for this effort?</p> <p>00;03;41;22 - 00;03;49;24<br /> Dr. Nishant Prasad<br /> Yes, You restated it very, very, very appropriately. I actually don't have anything to add to that.</p> <p>00;03;49;26 - 00;04;16;17<br /> Marie Cleary-Fishman<br /> You've got lots to add. But yeah, so my question, having been in quality for a very, very long time at this point in my life, you know, we know that so many interventions have been around and we've tried those. What performance improvement tools? PDSA Cycles? What kinds of things did you focus on this time and what made that different this time around than the previous times you may have tried?</p> <p>00;04;16;19 - 00;04;45;25<br /> Dr. Nishant Prasad<br /> Right. So that's a wonderful question because it's really the big change that we made. You know, we were all taught as part of, you know, addressing health care quality initiatives that you have to do, you know, an investigation and a root cause analysis. Right. And then you got to talk to the people where that, you know, that event occurred and and try to figure out what could we have done to prevent that occurrence.</p> <p>00;04;45;28 - 00;05;07;05<br /> Dr. Nishant Prasad<br /> That's what we were all taught. The change that we made and that's what we initially did before 2016. And unfortunately for us, it felt like we were spinning our wheels. Because we were coming up with interventions that didn't seem to be having the effect that we were hoping for and that we were not reducing our CLABSI rate.</p> <p>00;05;07;07 - 00;05;14;16<br /> Dr. Nishant Prasad<br /> So we took the tack of, and I'm sure this has been done before, is we copied the airline industry.</p> <p>00;05;14;18 - 00;05;15;00<br /> Marie Cleary-Fishman<br /> Okay.</p> <p>00;05;15;02 - 00;05;46;22<br /> Dr. Nishant Prasad<br /> We called in our experts. So we put together a very diverse team to focus and address the problem, of course, led by infection control and infectious diseases, because we know we're the sort of the stewards of infection control and health care associated infections at any hospital. And then we added to that everybody that takes part in the lifecycle of a central line.</p> <p>00;05;46;24 - 00;06;20;20<br /> Dr. Nishant Prasad<br /> So interventional radiology, the intravenous access team, right? The nurses on the floor to maintain the catheters, supply is right acquisition for a purchasing right What kind of supply should we purchasing for these catheters and their maintenance, right? The interns in the intensive care unit - all of these people were brought to the table and we had a committee formed and it was a sizable committee at the time and we discussed how to approach the problem.</p> <p>00;06;20;23 - 00;06;55;14<br /> Dr. Nishant Prasad<br /> And one of the things I remember, one of the one of the attendings speaking at that time is: we need to centralize our expertise. So one of the issues that we identified was that when we were doing the sort of the old teaching of having an RCA with the people who were caring for the patient, where the event occurred; you were asking the people who had the event what they think went wrong, where they're not necessarily subject matter experts in that occurrence.</p> <p>00;06;55;17 - 00;07;15;00<br /> Dr. Nishant Prasad<br /> So what we needed to do is reverse that. We needed to do our own evaluation before the root cause analysis. And that's what we started doing. So I felt infectious diseases, infection control and the other teams that were involved with those would do an incredibly detailed analysis of every single event.</p> <p>00;07;15;03 - 00;07;16;01<br /> Marie Cleary-Fishman<br /> Okay. Interesting.</p> <p>00;07;16;08 - 00;07;41;07<br /> Dr. Nishant Prasad<br /> So just like the airline industry does when there's a catastrophe on a plane, right? They will investigate with experts to figure out what happened. And sometimes they can even focus their investigation to the point where they can identify a single component, right? You've heard about those results of those investigations. We tried to get that level of granularity with our investigations and then we would have the RCA.</p> <p>00;07;41;09 - 00;07;49;21<br /> Marie Cleary-Fishman<br /> So you would actually look at the data and do that analysis prior to sitting down in the room with those at the frontline. Correct. Interesting.</p> <p>00;07;49;21 - 00;08;15;10<br /> Dr. Nishant Prasad<br /> And sometimes, the other thing we did is we greatly accelerated the initiation of that review process. As we would be monitoring - for example - when it comes to CLABSIs, we would be monitoring blood culture, positivity, these daily. And as soon as a blood culture turned up positive and it had the potential to be called a CLABSI we would start that review process to see, okay, is it truly a CLABSI?</p> <p>00;08;15;10 - 00;08;36;05<br /> Dr. Nishant Prasad<br /> If it is, what can we do and look at to see why was this a CLABSI? And once you do that deep investigation, sometimes even I would go and see the patient myself after talking to the primary team and say, Hey, listen, this might be a CLABSI, Do you mind if I see your patient and take a look and see what's going on and talk with the staff they've been caring for them?</p> <p>00;08;36;05 - 00;08;58;04<br /> Dr. Nishant Prasad<br /> They're always happy to accept our help in those regards. And when we go to the RCA, we're just adding to that incredibly detailed investigation because most of the time we actually had a pretty good idea of why the CLABSI had already occurred, and we're just adding more pieces to that puzzle with that RCA.</p> <p>00;08;58;06 - 00;09;22;13<br /> Marie Cleary-Fishman<br /> That's great. I really appreciate that and I think that's new, thinking or just kind of reordering things and really thinking about what's the best way to get at this. One thing in your case study, I just wanted to ask about, you mentioned including the palliative care team and and so that's not always a member of the team that we think about for central line infections.</p> <p>00;09;22;13 - 00;09;28;21<br /> Marie Cleary-Fishman<br /> Can you just briefly describe what palliative care was doing there and why you brought them in?</p> <p>00;09;28;24 - 00;09;59;05<br /> Dr. Nishant Prasad<br /> Yeah. So in that initial group of participating services that we put together to address this issue, we did not include palliative care in the beginning, but as a result of those incredibly detailed analysis, it turned out we identified cases where their input would have been very appropriate earlier on in the lifecycle of the central line. And so we chose to incorporate them into that group.</p> <p>00;09;59;05 - 00;10;27;10<br /> Dr. Nishant Prasad<br /> And as part of those, our RCA results, we decided that they would be an integral part and they were very helpful in addressing urgent palliative care issues, right? I know even right now, palliative care physicians and consultants are being employed as early as even the emergency room. It's great. You know, that was the new thing, right? So back then, getting them involved earlier was the recommendation.</p> <p>00;10;27;10 - 00;10;43;08<br /> Dr. Nishant Prasad<br /> But we as the committee could make that official recommendation to the department and the administration saying, hey, we need to get palliative care involved earlier on these patients, because quite frankly, a lot of patients that have central lines may benefit from earlier interventions from palliative care.</p> <p>00;10;43;15 - 00;11;12;07<br /> Marie Cleary-Fishman<br /> Right. That's great. I love that. It's including all of those across the care continuum. So it sounds like you've really built a lot of trust, a lot of credibility within your organization on that infection control prevention resources, the folks that you have in your organization. And if you were going to summarize the lessons learned, what are those things that in your experience that you've really learned?</p> <p>00;11;12;07 - 00;11;21;20<br /> Marie Cleary-Fishman<br /> I think you've identified a few things, but if you can also talk about those things that have really reinforced that trust and credibility of the team as lessons learned.</p> <p>00;11;21;22 - 00;11;56;05<br /> Dr. Nishant Prasad<br /> Thank you for that, because that's a perfect question. The real emphasis on our process is centralizing your expertise. And that's where you have to have people who understand infections and central lines, part of the analysis of every single CLABSI. See, because once you've got experts with that level of understanding, evaluating those events, they can really drill down to the why.</p> <p>00;11;56;07 - 00;12;30;01<br /> Dr. Nishant Prasad<br /> Why did that CLABSUI occur? And once they've identified that, then identifying effective interventions becomes much more easy and then you can implement your plan, do study, act cycles, because deciding what to do is incredibly time consuming and expensive, right? Some of these things do cost, you know, $0. You know, switching from one type of catheter to another type of catheter is a substantial cost, especially when the when the when the new catheter costs more money than the old catheter.</p> <p>00;12;30;04 - 00;12;42;29<br /> Dr. Nishant Prasad<br /> But having a good reason for why you're doing that is predicated on understanding that that switch, that intervention is very likely to have the desired effect.</p> <p>00;12;43;01 - 00;12;59;17<br /> Marie Cleary-Fishman<br /> And then also, as you mentioned, that I would imagine the role of leadership in your C-suite and maybe even the board plays a role in that trust and credibility from the front line all the way through. Can you just talk a little bit about the leadership support that you've had for this?</p> <p>00;12;59;19 - 00;13;28;11<br /> Dr. Nishant Prasad<br /> Oh, yeah. The support was incredible from our leadership in that once we were able to really tell them and define the problem, right, and then say, you know what, this we think is an intervention that's going to be helpful. They were incredibly supportive and I think they were more willing to support us because we had such detailed analysis.</p> <p>00;13;28;13 - 00;13;50;15<br /> Dr. Nishant Prasad<br /> It's not that we were saying, oh, it seems like or it looks like now we can actually point to individual cases and say, okay, this is what our analysis showed. This is what happened on that case. We think if we implement this process, it's going to make it better. And most of the time we had already done, you know, like a cheap you know, PDSA cycle just to see if it had a desired effect.</p> <p>00;13;50;15 - 00;14;12;17<br /> Dr. Nishant Prasad<br /> So we had an idea that, okay, now we need to request more resources or, you know, ask for more staffing or something like that to, to get the full, you know, protocol implemented throughout the hospital. And of course, they were always involved when we had to change workflows because sometimes the intervention required that kind of a workflow change.</p> <p>00;14;12;20 - 00;14;30;10<br /> Marie Cleary-Fishman<br /> Yeah, I think that's so important. I mean, if we go back to that fundamental and I say it over and over again, but structure, process and outcome, if you don't look at the workflow as part of that, then it's unlikely that structure alone is going to get you to the outcome you're looking at or looking for. So that's really important.</p> <p>00;14;30;12 - 00;14;53;19<br /> Marie Cleary-Fishman<br /> The timeframe that you worked on this covered the COVID 19 pandemic and you know, that had such an impact on our workforce, our supply chain, and on our organizational priorities, where we really had to shift how we were doing things, what we were doing. How did that impact this effort? Did it help? Did some of the change come out of that or what?</p> <p>00;14;53;21 - 00;14;56;07<br /> Marie Cleary-Fishman<br /> Can you talk a little bit about that experience?</p> <p>00;14;56;10 - 00;15;12;04<br /> Dr. Nishant Prasad<br /> Yeah. So the kind of good news for us is that most of our effective initiatives had already been implemented prior to the pandemic, sort of coming to New York City. And as you know, you know, Queens was hit pretty hard.</p> <p>00;15;12;10 - 00;15;12;29<br /> Marie Cleary-Fishman<br /> That's right.</p> <p>00;15;12;29 - 00;15;35;20<br /> Dr. Nishant Prasad<br /> So the good news is, is we were able to maintain pretty much all of our best practices throughout the pandemic. We didn't really suffer for it in any real way. Because one of the things that we identified even before the pandemic was these interventions are not sort of a fad diet, to put it that way. You can't start them and do them for a little bit until the problem is solved,</p> <p>00;15;35;20 - 00;15;48;08<br /> Dr. Nishant Prasad<br /> then stop. Yeah, sure, you have to switch and change and maintain. And so I like to say, you know, kind of the price of of good, good work is eternal vigilance in the world of infection control.</p> <p>00;15;48;11 - 00;16;17;28<br /> Marie Cleary-Fishman<br /> I love that. And that that was exactly the last place I wanted to go in really was to talk about sustainability. Yes. So you've touched on that a little bit. But any other lessons learned or issues around sustainability? Have you made any changes? Are you still maintaining the, you know, the work on your own beforehand, looking at the data and then moving to the RCA committee or what kinds of things can you tell me about sustainability?</p> <p>00;16;18;00 - 00;16;25;19<br /> Dr. Nishant Prasad<br /> Yeah, So in sustainability for us, you know, knock on wood, we haven't had a CLABSI seeing a little bit over a year now.</p> <p>00;16;25;19 - 00;16;28;06<br /> Marie Cleary-Fishman<br /> It's great, which is incredible.</p> <p>00;16;28;10 - 00;16;44;14<br /> Dr. Nishant Prasad<br /> It is still just as painstaking of a process because there are many, many potential CLABSIs and that review for each one of those is still done in exactly the same way that we did it when we were having concerns.</p> <p>00;16;44;14 - 00;16;45;17<br /> Marie Cleary-Fishman<br /> That's really great.</p> <p>00;16;45;17 - 00;16;56;08<br /> Dr. Nishant Prasad<br /> Yeah, you can't let off the gas. It's just not feasible to to stop doing what you know works. Quite frankly its common sense.</p> <p>00;16;56;10 - 00;17;19;22<br /> Marie Cleary-Fishman<br /> All of that. That's great. I mean, I think this is so important as we think about this whole process and the learnings that you've had, the best practice items that have come out of this. But, you know, we really are looking at how do we reinforce and sustain that trust with our patients. And every CLABSI belongs to someone's loved one and we really want to prevent those things.</p> <p>00;17;19;24 - 00;17;42;01<br /> Marie Cleary-Fishman<br /> Really driving to zero is what we all want right? So really love to hear that. I'd like to just ask you if there's any other ideas or suggestions that you'd like to share that I did not touch on today. Anything you would like to share, because this is a great opportunity for you to share your success and your best practices with everybody else in the field.</p> <p>00;17;42;01 - 00;17;55;16<br /> Marie Cleary-Fishman<br /> So now we get to best sustainability to spread, and that's really what we at the AHA like to try to facilitate across our members. So any last pieces of information you'd like to share?</p> <p>00;17;55;19 - 00;18;17;25<br /> Dr. Nishant Prasad<br /> Yeah, thank you for that. You know, I'd really like to just emphasize the couple of key points that I made. Number one, centralize your expertise, get people who know the subject materials, right? I'm not an interventional radiologist. I don't know how to place a central line. Last time I did that was when I was a resident and that was over a decade ago.</p> <p>00;18;17;27 - 00;18;49;23<br /> Dr. Nishant Prasad<br /> Right? So you really have to get those kinds of physicians and staff members involved in the evaluation of every single event. When there is an event that occurs that's related to their division, their input must be part of that RCA. And the evaluation should be done before the RCA. So again, just to reiterate, centralize your expertise and do a very, very detailed analysis because you really have to figure out that why as close as you can get to it.</p> <p>00;18;49;23 - 00;19;10;05<br /> Dr. Nishant Prasad<br /> You know, I know many things in medicine are many times ambiguous and you can't really, really know for sure what exactly happened that may have caused something, but you want to get as close as you possibly can, because then you'll make decisions for the interventions with much more clarity and you're more likely to have interventions that are effective.</p> <p>00;19;10;07 - 00;19;20;03<br /> Dr. Nishant Prasad<br /> So somebody just sort of taking our interventions and applying them to their facility may not be as effective because quite frankly, their problems may be different.</p> <p>00;19;20;06 - 00;19;40;23<br /> Marie Cleary-Fishman<br /> Very well said. Well, thank you, doctor. We really appreciate your insight, your ideas that have been innovative and really have driven to your success and really all of that sustainability and spread that we're sharing with others. So thank you so much for helping us to improve and to tell everybody about that journey.</p> <p>00;19;41;00 - 00;19;42;17<br /> Dr. Nishant Prasad<br /> Thank you for having me.</p> <p>00;19;42;20 - 00;20;15;19<br /> Tom Haederle<br /> This publication is part of a program of the Health Research and Educational Trust, supported by the Centers for Disease Control and Prevention - CDC - of the U.S. Department of Health and Human Services - HHS - under CDC/HHS as part of a financial assistance award totaling $75,000 with 100% funded by CDC/HHS. The contents are those of the authors and do not necessarily represent the official views of nor an endorsement by CDC, HHS, or the U.S. government.</p> </details> Wed, 26 Jul 2023 08:00:00 -0500 Central Line-Associated Bloodstream Infection (CLABSI) /sponsored-executive-dialogues/2023-03-13-/hospital-onset-bacteremia <div> </div>header.jumbotron {display:none} <div> /* center_body */ .center_body { /*margin-top:50px;*/ /* margin-bottom: 50px;*/ } .center_body h3 {} .center_body p { font-size: 16px } p.center_Intro { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 25px 0; font-weight: 700; font-size: 2em; } @media (max-width:768px) { p.center_Intro { line-height: 1.2em; font-size: 23px; font-size: 1.45em; } } .center_body .center_Lead { color: #63666A; font-weight: 300; line-height: 1.4; font-size: 21px; } /* center_body // */ /* Banner_Title_Overlay_Bar */ .Banner_Title_Overlay_Bar { position: relative; display: block; overflow: hidden; max-width: 1170px; margin: 0px auto 25px auto; } .Banner_Title_Overlay_Bar h1 { position: absolute; bottom: 40px; color: #003087; background-color: rgba(255, 255, 255, .8); width: 100%; padding: 20px 40px; font-size: 3em; box-shadow: 0 3px 8px -5px rgba(0, 0, 0, .6); } @media (max-width:991px) { .Banner_Title_Overlay_Bar h1 { bottom: 0px; margin: 0px; font-size: 2.5em; } } @media (max-width:767px) { .Banner_Title_Overlay_Bar h1 { font-size: 2em; text-align: center; text-indent: 0px; padding: 10px 20px; } } @media (max-width:530px) { .Banner_Title_Overlay_Bar h1 { position: relative; background-color: #63666A22; } } /* Banner_Title_Overlay_Bar // */ <header class="Banner_Title_Overlay_Bar"><img src="/sites/default/files/2023-03/BD_HospitalBacteremia_banner_1170x250.png" alt="Banner Image" width="1170" height="250"><div><h1>Hospital Onset Bacteremia</h1></div></header>/* CntMenuSub */ .CntMenuSub{ margin:20px 0px; padding-bottom: 5px; color: #afb1b1; letter-spacing: 1.5px; font-weight: 400; font-size: .7em; } .CntMenuSub .CntMenuBar{ border-bottom: 1px solid lightblue; } .CntMenuSub .CntMenuBar a:after{ content: "|"; padding: 0 3px 0 6px; color: #555; } .CntMenuSub .CntMenuBar a:last-child:after{ content: ""; } .CntMenuSub .CntMenuSubHome, .CntMenuSub .CntMenuSubParent{ text-transform: uppercase; color: #555; opacity: .9; } .CntMenuSub .CntMenuSubParent{ } .CntMenuSub .CntMenuSubChild{ } .CntMenuSub .CntMenuSubCurrent{ opacity: .7; } .CntMenuSub .CntMenuSubHome:hover, .CntMenuSub .CntMenuSubParent:hover{ text-transform: uppercase; color: #d50032; } /* CntMenuSub // */ <div class="container CntMenuSub"><div class="col-md-1"> </div><div class="col-md-10 row CntMenuBar"><a class="CntMenuSubHome" href="/education-events/aha-virtual-executive-dialogues">Executive Dialogues</a> <span class="CntMenuSubChild" id="CntMenuSubChild">Hospital Onset Bacteremia</span></div><div class="col-md-1"> </div></div><div class="row spacer"><div class="col-sm-3"><div><a href="/system/files/media/file/2023/04/BD_HospitalBacteremia_ebook_040523.pdf" target="_blank"><img src="/sites/default/files/2023-04/BD_HospitalBacteremia_cover_910x1220_040523.jpg" alt="Executive Dialogue | Hospital Onset Bacteremia: Hospital leaders’ attitudes on HOB sources, prevention and treatment" width="100%" height="100%"></a></div></div><div class="col-sm-9 center_body">.sponsortype { color: #9d2235; font-size: 1.5em; margin: 0px; font-weight: 700; } <p class="sponsortype">Executive Dialogue</p><h2>Hospital leaders’ attitudes on HOB sources, prevention and treatment</h2><p>Clinical studies have determined that hospital onset bacteremia (HOB) and false-positive blood cultures can have significant impacts on outcomes, length of stay and cost of care. The Centers for Disease Control & Prevention (CDC) is developing a quality measure reflecting HOB rates. The Centers for Medicare & Medicaid Services (CMS) included the HOB measure on its 2021 Measures Under Consideration list, which means the agency could propose the measure in future CMS hospital quality-reporting and value programs. With these developments, hospital leaders have a timely opportunity to give renewed consideration to how HOB is prevented, detected, treated and reported.<br><br>In October 2022, the ���������� Association (AHA) and Becton Dickinson (BD) held the “AHA Virtual Think Tank: Systematic approaches to health care-associated infection prevention,” an event for hospital and health system leaders in infectious disease, laboratory, nursing and other roles. The discussions identified additional information needs, which informed a survey to develop baseline data and additional insights about how various roles within hospitals view sources of HOB, its identification, how effectively HOB can be prevented and considerations for quality metrics. Results and commentary are presented in this report, which hospital leaders can use to assess their organizations, inform improvement efforts and prepare for potential reporting requirements.</p><div class="row">@media (min-width:768px){ .EDsponsorFloat{ float:right; } } @media (max-width:767px){ .EDLinkFloat{ position:relative; left:27%; } .EDsponsorFloat { text-align:center } } <div class="col-sm-6"><a class="btn btn-wide btn-primary EDLinkFloat" href="/system/files/media/file/2023/04/BD_HospitalBacteremia_ebook_040523.pdf" title="Executive Dialogue |Hospital Onset Bacteremia: Hospital leaders’ attitudes on HOB sources, prevention and treatment " data-view-context="top-level-view">Download the Report</a></div><div class="col-sm-6"><div class="EDsponsorFloat"><strong>Sponsored by: </strong><a href="https://www.bd.com/en-us/" target="_blank" rel="noopener nofollow"><img src="/sites/default/files/2023-03/BD_HOB_transparentlogo_834x313.png" alt="BD Logo" width="100%" height="100%"></a></div></div></div></div></div>.sp_CTA5_holder { margin-top:0px; border-bottom: solid 1px #555; padding-bottom: 50px; } .sp_CTA5_holder_last { border-bottom: solid 0px #555; } .sp_CTA5_holder >div{ overflow: auto; } .sp_CTA5_holder ul { list-style: none; /* Remove default bullets */ padding-left: 0px; /*width: calc(100% - 15%);*/ /*margin: 50px auto 0;*/ margin:auto 50px; } .sp_CTA5_holder ul li{ margin-bottom:7px; line-height: 1.5em; font-size:16px; } .sp_CTA5_holder ul li::before { content: " "; font-size: 1em; margin-right: 10px; display: inline-block; height: 12px; background-color: #9d2235; width: 12px; position: relative; top: 0px; -webkit-transform: rotate(45deg); -moz-transform: rotate(45deg); -o-transform: rotate(45deg); } .sp_CTA5_holder ul li{ padding-left:23px; text-indent:-23px; } .body ol>li, .body ul>li{ font-size:16px: } .sp_CTA5_holder h2 { color: #002855; /*! line-height: 2em; */ font-size: 2.15em; margin: 0 0 15px 0; /*! font-size: 30px; */ } .sp_CTA5_holder h3 { /*color: #002855;*/ line-height: 1em; /*font-size: 1.5em;*/ margin-bottom: 25px; margin-top:5px; font-size: 28px; } .sp_CTA5_section{ margin-top: 25px } .sp_CTA5_ImgShadow { /*background-color:green;*/ /* just a visual */ text-align: center } .sp_CTA5_ImgShadow { padding-bottom:75px; /* must match the padding on the img*/ margin: 0px; } .sp_CTA5_ImgShadow img{ width: calc(100% - 35px - 15px); -webkit-box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); -moz-box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); box-shadow: 50px -75px 0px 0px rgba(185, 217, 235, 1); position: relative; top: 75px; max-width: 490px; } @media (max-width:990px){ .sp_CTA5_ImgShadow img{ max-width: 350px;} } @media (max-width:990px){ .sp_CTA5_ImgShadow { padding-bottom:75px; /* must match the padding on the img*/ margin: 0px; margin-right: 40px } } <div class="row spacer sp_CTA5_holder sp_CTA5_holder_last"><div class="col-md-12"><h3>Major findings from the workshop and survey include:</h3><div class="sp_CTA5_section"><ul><li>1. When surveyed, 45% of respondents already were tracking HOB and another 20% planned to do so as soon as possible. The rest were waiting for specific developments (e.g., from CMS, CDC, the National Healthcare Safety Network [NHSN] or measure endorsement by the federal consensus-based entity).</li><li>2. Most HOB cases are considered preventable or partially preventable, especially those from central-line catheters and urinary sources, which are viewed as major contributors to HOBs.</li><li>3. Several resources are considered impactful for mitigating HOB given the perception that currently reportable health care-associated infections (HAIs) are thought to be significant sources of HOB. Therefore, current HAI bundles may help inform any new HOB bundle. Respondents identified best practices they would like included in an HOB bundle; these include visibility to HOB sources and respective prevention measures, timely pathogen identification if HOB occurs, and improvement in definitive therapy for HOB cases.</li><li>4. Streamlined microbiology lab workflows and communication with antimicrobial stewardship programs (ASPs) also may help facilitate faster identification and therapy for HOB events.</li><li>5. Respondents are optimistic that an HOB quality metric will improve patient safety and care, but expressed concerns about how metrics should be structured, achieving reporting consistency and the potential resources needed for reporting.</li><li>6. Nearly three out of four respondents (73%) believe future reporting metrics should consider patient demographics that may have predisposing clinical risk factors for HOB. However, respondents were split as to whether some populations should be excluded from HOB reporting, with 30% favoring some exclusions, 49% saying there should not be exclusions and 21% unsure.</li><li>7. Other opportunities for education differed by professional role, which will be important for leaders to consider when formulating plans and policies.</li></ul></div></div></div><h2>Participants</h2>/* people */ .people { margin-top: 50px; } .people img:nth-child(1) { border-radius: 200px; -moz-border-radius: 200px; -webkit-border-radius: 200px; margin-bottom: 10px; max-width:200px; /* for Transformation Talks */ display:block; /* for Transformation Talks */ margin:auto; /* for Transformation Talks */ } .people img:nth-child(1):hover { opacity: .7 } @media (max-width:991px) { .people { margin: auto; } .people p { text-align: center } } .ci_profile { margin-bottom: 30px; display: block; text-align:center /* this is for the "Executive Dialogue" page */ } @media (max-width:991px) { .ci_profile { text-align: center } } .ci_profile p { margin: 0 0 7px 0 } .ci_profile_name { font-weight: 700; font-size: 20px; } p.ci_profile_name { font-size: 1.5em; line-height:1.2em; margin-top:10px } 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(min-width:361px){ .people .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .people .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ flex: auto; width: calc((100% / 2) - 2px) /*Adjust % for the number per row, will override the bootstrap - Also needed for Safari*/; } } p.ci_profile_name { font-size: 1.5em; line-height:1.2em; margin-top:10px } .people .ci_profile_combined{ font-size:14px; line-height: 18px; } .people .ci_profile_combined span{ font-style: italic; } .people .ci_profile_combined:before{ content:""; border-bottom: solid 1px #55555522; display: block; clear: both; width: 85%; margin: 5PX auto 10px; } <div class="people"><div class="row rowEqual_768"><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2023-03/Demehin_Akin_300x300.jpg" alt="Akin Demehin" width="300" height="300"><p class="ci_profile_name">Akin Demehin, MPH</p><p class="ci_profile_title">Senior Director, Quality and Patient Safety Policy</p><p class="ci_profile_company">���������� Association</p>profile_combined</p> <p class="ci_profile_award">profile_award</p> <div class="ci_profile_social">profile_social</div>--></div><div class="col-md-4 col-sm-6 ci_profile"><img src="/sites/default/files/2023-03/Yu_Kalvin_300x300.jpg" alt="Kalvin Yu" width="300" height="300"><p class="ci_profile_name">Kalvin Yu, M.D., FIDSA</p><p class="ci_profile_title">Vice President, Medical and Scientific Affairs</p><p class="ci_profile_company">Becton Dickinson</p>profile_combined</p> <p class="ci_profile_award">profile_award</p> <div class="ci_profile_social">profile_social</div>--></div> <img alt="xxxxx" src="/sites/default/files/2021-11/profile_placeholder_300x300.jpg"> <p class="ci_profile_name">profile_name</p> <p class="ci_profile_title">profile_title</p> <p class="ci_profile_company">profile_company</p> <p class="ci_profile_combined">profile_combined</p> <p class="ci_profile_award">profile_award</p> <div class="ci_profile_social">profile_social</div> </div> --></div></div>Moderator</h2> <div class="people"> <div class="row rowEqual_768"> <div class="col-md-4 col-sm-6 ci_profile"> <img alt="Suzanna Hoppszallern" src="/sites/default/files/2022-08/Hoppszallern_Suzanna_300x300.jpg"> <p class="ci_profile_name">Suzanna Hoppszallern</p> <p class="ci_profile_title">Senior Editor</p> <p class="ci_profile_company">���������� Association</p> </div> </div> </div>-->@media (min-width:768px){ .rowEqual_768 { display: -webkit-box; display: -webkit-flex; display: -ms-flexbox; display: flex; flex-wrap: wrap; } .rowEqual_768>[class*='col-'] { -ms-flex: 1; /* IE 10 */ flex: auto; width: calc(33.3% - 2px) /*Safari Fix*/; } } .center_callout_3invert { background-color: #f6f6f6; text-align: center; /*margin-bottom:25px;*/ margin-top:30px; } .center_callout_3invert h4 { color: #002855; line-height: 1.2em; font-size: 30px; margin: 10px 0 30px 0; } .center_callout_3invert h3 { margin: 25px 0 0 0; color: #555; 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reduce disparities.</div> </div></div> <div class="article views-row"> <div class="views-field views-field-field-page-title-background"> <div class="field-content sed-thumb"> <a href="/2024-10-30/aligning-payers-and-partners-value-based-care" hreflang="en"><img loading="lazy" src="/sites/default/files/styles/small_200x200/public/2024-10/KnowEx_CorroHealthh_Medicaid_620x381.jpg?itok=HS9Y48c8" width="200" height="123" alt="KnowEx_CorroHealth_Medicaid" /> </a> </div> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-10-29T15:17:14-05:00">Oct 29, 2024</time> </span> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/2024-10-30/aligning-payers-and-partners-value-based-care" hreflang="en">Aligning Payers and Partners for Value-based Care</a></span> </div><div class="views-field views-field-body"> <div class="field-content">As value-based care models grow, hospitals, providers and payers need to align goals and incentives to improve patient outcomes and reduce costs.</div> </div></div> <div class="article views-row"> <div class="views-field views-field-field-page-title-background"> <div class="field-content sed-thumb"> <a href="/2024-09-26/transforming-behavioral-health-journey" hreflang="en"><img loading="lazy" src="/sites/default/files/styles/small_200x200/public/2024-09/Iris-Telehealth-banner-620x381.jpg?itok=QQ9C-7Mp" width="200" height="123" alt="Iris-Telehealth-banner-620x381" /> </a> </div> </div><div class="views-field views-field-created"> <span class="field-content"><time datetime="2024-09-25T14:49:38-05:00">Sep 25, 2024</time> </span> </div><div class="views-field views-field-title"> <span class="field-content"><a href="/2024-09-26/transforming-behavioral-health-journey" hreflang="en">Transforming the Behavioral Health Journey</a></span> </div><div class="views-field views-field-body"> <div class="field-content">Transforming the behavioral health journey with strategic initiatives to build a sustainable and coordinated behavioral health services continuum.</div> </div></div> </div> </div> <div class="more-link"><a href="/aha-knowledge-exchange-archive">View All: AHA Knowledge Exchange</a></div> </section> </div> </div></div> Mon, 13 Mar 2023 15:12:12 -0500 Central Line-Associated Bloodstream Infection (CLABSI) /news/headline/2022-04-08-aha-ahrq-release-toolkit-help-hospitals-prevent-icu-infections <p>The AHA and Agency for Healthcare Research and Quality have released a <a href="/center/hret/infection-prevention-icus">toolkit</a> to help hospitals prevent central line-associated bloodstream infections and catheter-associated urinary tract infections in intensive care units. The customizable toolkit offers resources to assess current clinical and safety practices, implement a reduction plan and overcome common cultural and technical challenges in reduction efforts. It includes a playbook on how to apply AHRQ’s proven Comprehensive Unit-based Safety Program in the ICU.</p> Fri, 08 Apr 2022 14:17:03 -0500 Central Line-Associated Bloodstream Infection (CLABSI) /center/strive Tue, 20 Oct 2020 15:40:57 -0500 Central Line-Associated Bloodstream Infection (CLABSI)