2433. Implementation of Midline Vascular Access Program and Reduction of Central Line-Associated Bloodstream Infections (CLABSI) in an Intensive Care Unit at a Community-Based Hospital

Abstract

Abstract Background Central venous catheter (CVC) placement is the most frequently performed procedure in acute care hospitals for various indications in multiple clinical settings. CVCs are the main source of hospital-acquired bloodstream infections in the United States (US). Central line-associated bloodstream infections (CLABSIs) constitute a significant contributor to gross healthcare expenditure in the US health system. Reduction of the duration of the CVCs is a key factor to decrease the risk of CLABSI. Methods A retrospective study was conducted to compare the annual incidence of CLABSI rate, total CVC days, and device utilization ratio before and after the implementation of a midline vascular access program as an institutional-based intervention to reduce the CLABSI rate in the intensive care unit (ICU). Results The midline vascular access program was started in June 2021. Two study groups were compared (Group 1 includes the study period from January 2019 to June 2021 and Group 2 from July 2021 to December 2022). CLABSI number decreased from 22 to nine. The CLABSI rate (measured as CLABSI number per 1000 CVC days) decreased by 52% (6.8% o 3.3%) (P < 0.05) . There was a reduction in the total CVC days (3198 days in Group 1 vs 2731 days in Group 2) but it was not significantly associated with the decline in the CLABSI rate (P=0.0702). A 60% significant reduction rate was observed in the device utilization ratio (measured as total CVS days/ total patients’ days) (0.6 to 0.3) (P < 0.001), which was significantly associated with the decrease in the CLABSI rate (P< 0.001).Table 1.Results of study variables between the two study groupsFigure 1.The monthly number of CLABSI infections during the study period. Conclusion The midline vascular access program was associated with a reduction in the CLABSI rate per 1000 CVC days and the device utilization ratio in our ICU. The authors of this project are currently conducting a larger prospective case-control study to ascertain our preliminary study’s results which have some limitations attributed to its retrospective nature and sample size. Disclosures All Authors: No reported disclosures