Comparison of NHSN-defined central venous catheter day counts with a method that accounts for concurrent catheters

Area of Science:

• Healthcare quality improvement
• Infection prevention and control
• Medical device utilization

Background:

• Current central venous catheter (CVC) day definitions may not accurately reflect patient device exposure.
• Concurrent CVC use is common but often not fully accounted for in standard metrics.
• Accurate device day counts are crucial for calculating infection rates like central line-associated bloodstream infections (CLABSI).

Purpose of the Study:

• To evaluate the impact of a revised CVC day definition that incorporates concurrent CVCs.
• To assess how accounting for concurrent CVCs affects calculated CLABSI rates.
• To determine if a more inclusive CVC day definition improves the accuracy of infection surveillance.

Main Methods:

• Retrospective analysis of patient data involving central venous catheters.
• Comparison of traditional CVC day calculation methods versus a new method including concurrent CVCs.
• Calculation and comparison of CLABSI rates using both CVC day definitions.

Main Results:

• The revised CVC day definition, including concurrent devices, increased total device day counts by 8.5%.
• Despite the increase in device days, the overall central line-associated bloodstream infection (CLABSI) rates showed only a mild impact.
• The findings suggest that while concurrent CVCs add to device exposure, their contribution to CLABSI rates may be proportionally smaller than initially assumed.

Conclusions:

• A CVC day definition that accounts for concurrent devices provides a more comprehensive measure of device utilization.
• The revised definition minimally impacts CLABSI rates, indicating current surveillance methods may be largely robust.
• Further research could explore the clinical significance of concurrent CVCs on patient outcomes beyond infection rates.