Present on Admission Checklist to Complement a CLABSI Reduction Plan in a Quaternary Care Center

Area of Science:

• Infection Control
• Patient Safety
• Clinical Diagnostics

Background:

• Lack of standardized methods for assessing central lines present on admission (POA) risk for central line-associated bloodstream infections (CLABSI).
• Need for a validated tool to identify patients at high risk of CLABSI-POA.

Purpose of the Study:

• To validate a screening tool for identifying patients at risk of CLABSI-POA.
• To assess the tool's impact on CLABSI rates and diagnosis timing.

Main Methods:

• Development of a four-criterion questionnaire for CLABSI-POA risk assessment.
• Screening of patients with central lines POA across general surgery, transplant, hepatology, and oncology units.
• Obtaining blood cultures for at-risk patients and analyzing CLABSI counts pre- and post-implementation.

Main Results:

• 56% of screened patients (n=204) tested positive for CLABSI-POA risk.
• 15% (n=30) of blood cultures were positive.
• CLABSI counts decreased post-implementation, with a significant shift in diagnosis timing (median 6.5 vs. 15 days, p=.038).

Conclusions:

• A screening questionnaire for central line POA can facilitate early identification of bloodstream infections.
• The validated tool shows promise in reducing CLABSI rates and improving patient outcomes.
• The tool implementation was achieved without a corresponding increase in testing resources.