Abstract
Central line-associated bloodstream infections (CLABSI) are a very common source of healthcare-associated infection (HAI). Incidence of CLABSI has been significantly reduced through the efforts of nurses, healthcare providers, and infection preventionists. Extrinsic factors such as recently enacted legislation and mandatory reporting have not been closely examined in relation to changes in rates of HAI. The following review will examine evidence-based practices related to CLABSI and how they are reported, as well as how the Affordable Care Act, mandatory reporting, and pay-for-performance programs have affected these best practices related to CLABSI prevention. There is a disconnect in the methods and guidelines for reporting CLABSI between these programs, specifically among local monitoring agencies and the various federal oversight organizations. Future research will focus on addressing the gap in what defines a CLABSI and whether or not these programs to incentivize hospital to reduce CLABSI rates are effective.
Highlights
Central line-associated bloodstream infections (CLABSI) are the third most frequent cause of healthcare-associated infection (HAI; The Joint Commission, 2012)
Nurses are on the frontline of CLABSI prevention, contributing to the 58% decrease in CLABSI rates that has occurred between 2001 and 2009 (CDC, 2016)
Hospitals and infection preventionists use the laboratory-confirmed bloodstream infection (LCBI) system to report to the National Healthcare Safety Network (NHSN), while healthcare providers treat patients with CLABSI, who are assigned codes based on the World Health Organization’s International Classification of Diseases (ICD) and used by the CMS and the NHSN
Summary
Central line-associated bloodstream infections (CLABSI) are the third most frequent cause of healthcare-associated infection (HAI; The Joint Commission, 2012). The majority of states require hospitals to report their CLABSIs to the NHSN through providers coding with ICD and/or infection preventionists following LCBI guidelines. Hospitals and infection preventionists use the LCBI system to report to the NHSN, while healthcare providers treat patients with CLABSI, who are assigned codes based on the World Health Organization’s ICD and used by the CMS and the NHSN. Another study measuring similar variables found that hospital costs decreased and patient satisfaction increased where these programs were in place (Stanowski, Simpson, & White, 2015) It appears that initial studies on pay-for-performance programs are finding positive outcomes, but aspects of mandatory reporting are widely left out of their research. This seems to indicate that the effectiveness of pay-for-performance programs is specific to each hospital’s financial situation
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