Last time, we said that some important groups had upped their interest in fighting HAIs (Healthcare-Associated Infections) and CLABSIs (Central Line-Associated Bloodstream Infections). Now, we are seeing more organizations joining the bandwagon. The CDC (Centers for Disease Control), APIC (Association of Professionals in Infection Control And Epidemiology), SHEA (the Society for Healthcare Epidemiology of America), IDSA (the Infectious Diseases of Society of America), ASTHO (Association of State and Territorial Health Officials, CSTE (Council of State and Territorial Epidemiologists), and PIDS (the Pediatric Infectious Diseases Society) have all come together to issue a joint statement, calling for the elimination of HAIs. Exhale. That’s a lot of groups reaching for a big goal.
Elimination. In this case, elimination is defined as the maximal reduction of the incidence of infection caused by a specific agent in a defined geographical area as a result of deliberate efforts requiring continued measures to prevent re-establishment of transmission. It’s going to take some money and a whole lot of cooperation.
Let’s review for a second. Upwards of a quarter-million CLABSIs occur each year in the United States. Each one results in extra treatment costs. Plus a longer hospital stay for the patient. The CDC estimates that each CLABSI results in nearly $17,000 of extra costs and a three-week extension to a patient’s hospital stay. If they survive. Nearly 99,000 patients die annually as a result of HAIs. About one-third of those are due to CLABSIs.
One of the biggest problems with CLABSIs in the past was ignorance. For years and years, these infections were considered inevitable. Sorry, you got an infection, dude, nothing we can do about it. But now we know differently. Now, these bugs ARE preventable. We in healthcare just have to follow the rules.
It’s estimated that up to seventy percent of CLABSIs may be preventable by the use of evidence-based strategies. In a Johns Hopkins Quality and Research Group study of 103 ICUs in Michigan, it was found that after three years of improved use of evidence-based interventions and a culture of patient safety, there was a nearly sixty percent reduction in the baseline CLABSI rate. Wow! Say it again – Wow! That translates to two hundred million dollars of excess costs saved. And two thousand lives saved. Is one more Wow too much?
Unhappy patients, irate insurers, a better understanding of the pathogenesis of CLABSIs, and this sort of research information has lead to the rise of a “zero tolerance” way of thought. Let us not settle for meeting the “acceptable” levels of CLABSI incidence. Let’s go for total annihilation! Following the rules puts this new goal within reach of almost every healthcare setting.
Information for this blog post was derived from a monograph by The Joint Commission titled Preventing Central Line-Associated Bloodstream Infections: A Global Challenge, A Global Perspective. May 2012.