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A vascular access and midlines program can decrease hospital-acquired central line-associated bloodstream infections

Rahul Pathak1, Sumalatha Gangina1, Falina Jairam1

  • 1University of Central Florida School of Medicine and Heart of Florida Regional Medical Center, Davenport, FL, USA, rahul.pathak@ucf.edu.

Therapeutics and Clinical Risk Management
|September 4, 2018
PubMed
Summary

Implementing a midline program significantly reduced central line days and infections, lowering costs and improving patient care in community hospitals. This strategy is recommended for widespread adoption.

Keywords:
central line-associated bloodstream infectionshospital length of stayhospital-acquired infectionsmidlinequality of carevenous access

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Area of Science:

  • Healthcare management
  • Infection control
  • Vascular access devices

Background:

  • Central line-associated bloodstream infections (CLABSIs) pose significant risks, including increased costs and length of stay.
  • Midline catheters offer a potential alternative to central lines, aiming to reduce complications.
  • Implementing a vascular access program can drive positive changes in infection rates and resource utilization.

Purpose of the Study:

  • To evaluate the impact of a midline program on central line catheter-days and CLABSI rates.
  • To assess the reduction in incidence and associated costs of CLABSIs.
  • To determine the feasibility of a midline program in a community hospital setting.

Main Methods:

  • Data collection on central line catheter-days, patient-days, and CLABSIs from 2012 to 2017.
  • Implementation of Centers for Disease Control and Prevention (CDC)-based recommendations for CLABSI prevention starting in June 2014.
  • Introduction of a midline program in June 2015 to replace central lines where appropriate.

Main Results:

  • CDC recommendations alone showed a non-significant decrease in CLABSI rates.
  • The combined strategy of CDC recommendations and a midline program led to a statistically significant reduction in central line days per patient-day.
  • The integrated approach also resulted in a significant decrease in the CLABSI rate.

Conclusions:

  • Hospitals are encouraged to develop midline programs to minimize central line usage.
  • Reducing central line catheter-days through midline catheter utilization can lower infection rates.
  • This strategy contributes to improved patient safety and cost-effectiveness in healthcare settings.