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

There are no standardized methods to assess central lines that are present on admission (POA) for risk of central line-associated bloodstream infections (CLABSI). This pilot study validated a tool to identify patients at risk of CLABSI-POA.

A questionnaire to assess patients' risk of CLABSI-POA was developed based on four criteria. If any criteria were positive, two sets of blood cultures were obtained. From November 2023 to September 2025 (Phase 1), all patients admitted to general & colorectal surgery, liver & intestinal transplant, or hepatology with a central line POA were screened. Phase 2 of the pilot study began in June 2024, which included screening of patients admitted to the oncology units.

366 patients were screened for CLABSI POA, with 56% (n = 204) screening positive. Blood cultures were drawn for 97% (n = 198) of at-risk patients. In total, 15% (n = 30) of cultures were positive. After the pilot study, CLABSI counts across all nursing units in the pilot study decreased, and the time to CLABSI diagnosis shifted (median 6.5 days prepilot study vs. 15 days postpilot study) ( p = .038) likely denoting true hospital-acquired CLABSIs, without a corresponding increase in resources for testing ( p = .06).

Implementation of a screening questionnaire for patients with central line POA can lead to early identification of patients presenting with blood stream infections.