Study in American Journal of Critical Care details how Select Medical decreased CLABSI rates 29 percent in 30 long-term acute care hospitals
ALISO VIEJO, Calif. — March 1, 2016 — A central catheter maintenance bundle developed to prevent a common healthcare-associated infection had an immediate effect of decreasing rates of central line-associated bloodstream infections (CLABSIs), according to a study in the American Journal of Critical Care (AJCC).
The AJCC article, “Use of a Central Catheter Maintenance Bundle in Long-Term Acute Care Hospitals,” details the 14 components of the central catheter maintenance bundle and a five-item checklist to monitor compliance.
Patients with chronic critical illnesses are at high risk for healthcare-associated infections, especially when they have a central catheter for an extended period.
In an effort to decrease CLABSI rates, a quality improvement team from Select Medical developed and implemented a central catheter maintenance bundle for patients admitted to 30 long-term acute care hospitals (LTACHs), which are specialty hospitals that treat patients who require extended hospitalization for chronic critical illness. LTACH patients typically arrive with a central catheter already in place.
The research team used infection prevention guidelines from the Centers for Disease Control and Prevention (CDC) as the core of the bundle, with mandatory use of alcohol-based central catheter caps and chlorhexidine gluconate dressings. Ongoing education of clinical staff about the protocol and a checklist to track compliance were also key elements of the initiative. Each hospital identified staff nurses with demonstrated competency in the care of central catheters to monitor implementation of the bundle for the initial six months of the study.
About 65 percent of patients admitted during the study period were admitted with a central catheter. The researchers reviewed the medical records of 6,660 patients discharged during the 14 months prior to the study and 6,559 patients discharged after implementation of the bundle. Patient days and central catheter days before and after the bundle was implemented were comparable.
Following implementation of the central catheter maintenance bundle, the CLABSI standardized infection rate was reduced 29 percent. In addition, a mean reduction of 4.5 CLABSIs per hospital occurred for 14 months after implementation of the bundle.
Study results demonstrate that the bundle, with attention to compliance, resulted in a significant and sustained reduction in the overall mean CLABSI rate in the participating hospitals for 14 months.
“Our results encourage the development and implementation of similar bundles as effective infection reduction strategies in LTACHs,” said lead author Antony Grigonis, PhD, Vice President of Quality and Healthcare Analytics at Select Medical. The company, based in Mechanicsburg, Pennsylvania, is one of the nation’s largest providers of specialized acute and post-acute care.
“Preventing these infections can help reduce complications and the length of stay for other patients,” Grigonis said. “This infection reduction could also translate to a savings of approximately $3.7 million annually for the 30 Long-Term Acute Care Hospitals studied.”
To access the article and its full-text PDF, visit the AJCC website at www.ajcconline.org.
About Select Medical: Select Medical is one of the nation's largest providers of specialized acute and post-acute care. Its network of more than 40,000 employees operates or supports more than 100 hospitals specializing in long-term acute care, 17 rehabilitation hospitals, and more than 1,000 outpatient clinics offering physical and occupational therapy. In addition, Select Medical offers contract therapy services at nearly 500 locations and occupational medicine and urgent care through Concentra. Select Medical (NYSE: SEM) was founded in 1996 and is based in Mechanicsburg, Pennsylvania. For more information, visit selectmedical.com or youtube.com/selectmedical.
About the American Journal of Critical Care: The American Journal of Critical Care (AJCC), a bimonthly scientific journal published by the American Association of Critical-Care Nurses, provides leading-edge clinical research that focuses on evidence-based practice applications. Established in 1992, it includes clinical and research studies, case reports, editorials and commentaries. AJCC enjoys a circulation of more than 106,000 acute and critical care nurses and can be accessed at www.ajcconline.org.
About the American Association of Critical-Care Nurses: Founded in 1969 and based in Aliso Viejo, California, the American Association of Critical-Care Nurses (AACN) is the largest specialty nursing organization in the world. AACN represents the interests of more than 500,000 acute and critical care nurses and includes more than 225 chapters worldwide. The organization's vision is to create a healthcare system driven by the needs of patients and their families in which acute and critical care nurses make their optimal contribution.