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Research Letter
January 14, 2020

Differences in Central Line–Associated Bloodstream Infection Rates Based on the Criteria Used to Count Central Line Days

Author Affiliations
  • 1Lucile Packard Children’s Hospital Stanford, Palo Alto, California
  • 2Department of Electrical Engineering, Stanford University School of Engineering, Stanford, California
JAMA. 2020;323(2):183-185. doi:10.1001/jama.2019.18616

Central line–associated bloodstream infection (CLABSI) rates are an important quality performance indicator associated with patient morbidity, mortality, and increased costs. Hospital CLABSI rates are tracked, reported, and tied to reimbursement by the Centers for Medicare & Medicaid Services. This creates incentives for hospitals to reduce CLABSI rates with standardized best practices for the management of central lines.1,2 Between 2008 and 2017 the CLABSI standardized infection rate reported to the National Healthcare Safety Network (NHSN) fell by approximately 49% in acute care hospitals.3 The NHSN reporting guidelines specify 3 options for measuring the number of central line days: a once-a-day count at a fixed time for all patients with a central line; a sampling-based approximation to the once-a-day count; and an electronic count that may be used “after a validation of a minimum 3 consecutive months proves the data to be within 5% (+/–) of the manually collected once-a-day counts.”4 We evaluated the differences in CLABSI rates per 1000 central line days based on the choice of the time used for the once-a-day count and based on the use of electronic data collection.

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