Patient Safety Measures:
Central Line Associated Bloodstream Infections
What are we measuring and why?
Some patients in an intensive care unit (ICU) need frequent intravenous medications, blood, fluid replacement and/or nutrition. To aid in this, they may have a central venous catheter, or central line, placed into a vein. Central lines are important, but can cause problems. They disrupt the skin and can sometimes cause infections when bacteria spread to the bloodstream. This is called a "central line associated bloodstream infection," and is quite serious. Hospitals can reduce or eliminate these infections by taking a few steps. Proper hand hygiene, sterile precautions, skin cleaning, and central line insertion and maintenance techniques are all vital. We measure the number of bloodstream infections in our ICUs per 1,000 days of central line use.
How are we doing and how do we compare to best practice?
To make comparisons meaningful, healthcare quality experts compare how many infections occur for every 1,000 days that central lines are in place. All Partners hospital ICUs are performing better than or the same as the Massachusetts State benchmark for the time period July 1, 2010 - June 30, 2011.
What are we doing to improve?
Infection control experts and caregivers at Partners share data and care practices. They also look for more ways to reduce or eliminate bloodstream infections in our ICUs. We conducted a comprehensive review of successful practices and we work hard to promote these practices, which include:
- Being mindful in using these lines only when absolutely needed
- Using checklists to make sure all the right steps are taken when inserting a central line
- Using hand hygiene and careful protocols for line maintenance
Intensive Care Unit (ICU) / Hospital Information
Partners Healthcare hospitals provide care in separate types of Intensive Care Units, or ICUs, and report data on care delivered in those ICUs. The risk of infection can vary in different ICU types based on the types of patients in the unit and the kind of treatments they receive. Because of this, the data in the tables below is reported separately for each ICU type.
How to interpret the table below
The tables below show central line associated bloodstream infection data for Partners hospitals from July 1, 2010 – June 30, 2011. Each location strives for zero infections.
The data for Partners hospital ICUs is compared to the predicted rate of infections for each ICU. The predicted rate of infections is based on the average number of infections in all Massachusetts hospitals. The data is then interpreted to see if the number of infections is statistically lower, the same, or statistically higher than the predicted rate of infections.
Charts for Central Line Associated Bloodstream Infections
- Brigham &
Women's Hospital - Massachusetts
General Hospital - Newton-Wellesley
Hospital - BWH Faulker
Hospital - North Shore
MC - Salem - North Shore
MC - Union
Central Line Associated Bloodstream Infections
Interpretation:
Lower: The number of infections was lower (better) than the predicted number of infections
Same: The number of infections was the same as the expected rate of infections
Higher: The number of infections was higher (worse) than the predicted number of infections
| Unit | Infections | Line Days | Rate | Predicted Infections | SIR | Compared to Predicted Infections |
|---|---|---|---|---|---|---|
| Medical Cardiac | 3 | 1815 | 1.65 | 2.99 | 1 | Same |
| Surgical Cardiothoracic | 3 | 4796 | 0.63 | 4.29 | 0.7 | Same |
| Medical | 9 | 4056 | 2.22 | 6.76 | 1.33 | Same |
| Neurosurgical | 1 | 2373 | 0.42 | 2.37 | 0.42 | Same |
| Surgical | 12 | 5498 | 2.18 | 7.42 | 1.62 | Same |
| Neonatal | 3 | 2413 | 1.24 | 6.39 | 0.47 | Same |
Partners HealthCare Data Period: July 1, 2010 - June 30, 2011
SIR: Standardized Infection Ratio – The standardized infection ration (SIR) is a summary measure used to track Healthcare-Associated Infections (HAIs) at a national, state, or local level over time. The SIR adjusts for patients of varying risk within each facility. The SIR compares the actual number of HAIs reported with the baseline Massachusetts experience, adjusting for several risk factors that have been found to be significantly associated with differences in infection incidence. In other words, an SIR greater than 1.0 indicates that more HAIs were observed than predicted, accounting for differences in the types of patients followed; conversely an SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections - The predicted rate of infections is based on the average number of infections in all Massachusetts Hospitals. It is calculated by multiplying the state average by central line days.
Partners HealthCare Source: Massachusetts Department of Public Health Report, February 8, 2012
Central Line Associated Bloodstream Infections
Interpretation:
Lower: The number of infections was lower (better) than the predicted number of infections
Same: The number of infections was the same as the expected rate of infections
Higher: The number of infections was higher (worse) than the predicted number of infections
| Unit | Infections | Line Days | Rate | Predicted Infections | SIR | Compared to Predicted Infections |
|---|---|---|---|---|---|---|
| Burn | 2 | 727 | 2.75 | 3.74 | 0.54 | Same |
| Medical Cardiac | 5 | 3991 | 1.25 | 6.57 | 0.76 | Same |
| Surgical Cardiothoracic | 4 | 4196 | 0.95 | 3.76 | 1.07 | Same |
| Medical | 5 | 4686 | 1.07 | 7.81 | 0.64 | Same |
| Pediatric Medical/Surgical | 5 | 886 | 5.64 | 1.91 | 2.61 | Same |
| Neurosurgical | 1 | 3110 | 0.32 | 3.10 | 0.32 | Same |
| Surgical | 1 | 5191 | 0.19 | 7.00 | 0.14 | Lower |
| Neonatal | 1 | 1966 | 0.51 | 5.11 | 0.2 | Same |
Partners HealthCare Data Period: July 1, 2010 - June 30, 2011
SIR: Standardized Infection Ratio – The standardized infection ration (SIR) is a summary measure used to track Healthcare-Associated Infections (HAIs) at a national, state, or local level over time. The SIR adjusts for patients of varying risk within each facility. The SIR compares the actual number of HAIs reported with the baseline Massachusetts experience, adjusting for several risk factors that have been found to be significantly associated with differences in infection incidence. In other words, an SIR greater than 1.0 indicates that more HAIs were observed than predicted, accounting for differences in the types of patients followed; conversely an SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections - The predicted rate of infections is based on the average number of infections in all Massachusetts Hospitals. It is calculated by multiplying the state average by central line days.
Partners HealthCare Source: Massachusetts Department of Public Health Report, February 8, 2012
Central Line Associated Bloodstream Infections
Interpretation:
Lower: The number of infections was lower (better) than the predicted number of infections
Same: The number of infections was the same as the expected rate of infections
Higher: The number of infections was higher (worse) than the predicted number of infections
| Unit | Infections | Line Days | Rate | Predicted Infections | SIR | Compared to Predicted Infections |
|---|---|---|---|---|---|---|
| Medical/Surgical | 1 | 980 | 1.02 | 1.10 | 0.91 | Same |
Partners HealthCare Data Period: July 1, 2010 - June 30, 2011
SIR: Standardized Infection Ratio – The standardized infection ration (SIR) is a summary measure used to track Healthcare-Associated Infections (HAIs) at a national, state, or local level over time. The SIR adjusts for patients of varying risk within each facility. The SIR compares the actual number of HAIs reported with the baseline Massachusetts experience, adjusting for several risk factors that have been found to be significantly associated with differences in infection incidence. In other words, an SIR greater than 1.0 indicates that more HAIs were observed than predicted, accounting for differences in the types of patients followed; conversely an SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections - The predicted rate of infections is based on the average number of infections in all Massachusetts Hospitals. It is calculated by multiplying the state average by central line days.
Partners HealthCare Source: Massachusetts Department of Public Health Report, February 8, 2012
Central Line Associated Bloodstream Infections
Interpretation:
Lower: The number of infections was lower (better) than the predicted number of infections
Same: The number of infections was the same as the expected rate of infections
Higher: The number of infections was higher (worse) than the predicted number of infections
| Unit | Infections | Line Days | Rate | Predicted Infections | SIR | Compared to Predicted Infections |
|---|---|---|---|---|---|---|
| Medical/Surgical | 1 | 901 | 1.11 | 1.01 | 0.99 | Same |
Partners HealthCare Data Period: July 1, 2010 - June 30, 2011
SIR: Standardized Infection Ratio – The standardized infection ration (SIR) is a summary measure used to track Healthcare-Associated Infections (HAIs) at a national, state, or local level over time. The SIR adjusts for patients of varying risk within each facility. The SIR compares the actual number of HAIs reported with the baseline Massachusetts experience, adjusting for several risk factors that have been found to be significantly associated with differences in infection incidence. In other words, an SIR greater than 1.0 indicates that more HAIs were observed than predicted, accounting for differences in the types of patients followed; conversely an SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections - The predicted rate of infections is based on the average number of infections in all Massachusetts Hospitals. It is calculated by multiplying the state average by central line days.
Partners HealthCare Source: Massachusetts Department of Public Health Report, February 8, 2012
Central Line Associated Bloodstream Infections
Interpretation:
Lower: The number of infections was lower (better) than the predicted number of infections
Same: The number of infections was the same as the expected rate of infections
Higher: The number of infections was higher (worse) than the predicted number of infections
| Unit | Infections | Line Days | Rate | Predicted Infections | SIR | Compared to Predicted Infections |
|---|---|---|---|---|---|---|
| Surgical Cardiothoracic | 0 | 864 | 0 | 0.77 | 0 | Same |
| Medical/Surgical | 3 | 2354 | 1.27 | 2.59 | 1.16 | Same |
Partners HealthCare Data Period: July 1, 2010 - June 30, 2011
SIR: Standardized Infection Ratio – The standardized infection ration (SIR) is a summary measure used to track Healthcare-Associated Infections (HAIs) at a national, state, or local level over time. The SIR adjusts for patients of varying risk within each facility. The SIR compares the actual number of HAIs reported with the baseline Massachusetts experience, adjusting for several risk factors that have been found to be significantly associated with differences in infection incidence. In other words, an SIR greater than 1.0 indicates that more HAIs were observed than predicted, accounting for differences in the types of patients followed; conversely an SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections - The predicted rate of infections is based on the average number of infections in all Massachusetts Hospitals. It is calculated by multiplying the state average by central line days.
Partners HealthCare Source: Massachusetts Department of Public Health Report, February 8, 2012
Central Line Associated Bloodstream Infections
Interpretation:
Lower: The number of infections was lower (better) than the predicted number of infections
Same: The number of infections was the same as the expected rate of infections
Higher: The number of infections was higher (worse) than the predicted number of infections
| Unit | Infections | Line Days | Rate | Predicted Infections | SIR | Compared to Predicted Infections |
|---|---|---|---|---|---|---|
| Medical/Surgical | 0 | 1572 | 0 | 1.73 | 0 | Same |
Partners HealthCare Data Period: July 1, 2010 - June 30, 2011
SIR: Standardized Infection Ratio – The standardized infection ration (SIR) is a summary measure used to track Healthcare-Associated Infections (HAIs) at a national, state, or local level over time. The SIR adjusts for patients of varying risk within each facility. The SIR compares the actual number of HAIs reported with the baseline Massachusetts experience, adjusting for several risk factors that have been found to be significantly associated with differences in infection incidence. In other words, an SIR greater than 1.0 indicates that more HAIs were observed than predicted, accounting for differences in the types of patients followed; conversely an SIR of less than 1.0 indicates that fewer HAIs were observed than predicted.
Predicted Infections - The predicted rate of infections is based on the average number of infections in all Massachusetts Hospitals. It is calculated by multiplying the state average by central line days.
Partners HealthCare Source: Massachusetts Department of Public Health Report, February 8, 2012