ISR 85 - Navigating Infection Challenges: A New York City Intensive Care Unit’s Triumph over Central Line-associated Bloodstream Infections with Precision

Background: Central line-associated bloodstream infections (CLABSIs) present significant challenges, influencing hospital stays, finances, and patient outcomes. In a New York City level-one trauma hospital's 18-bed Adult Intensive Care unit (ICU), including four burn beds, four patients experienced CLABSIs between Q1 2021 and Q3 2023. This study assesses the impact of a refined CLABSI Vigilance Matrix, that integrated education, thorough documentation, and stringent maintenance of central lines.

Methods: Data from the National Healthcare Safety Network (NHSN) database, spanning 2021 to 2023, were analyzed. Patients with CLABSIs were scrutinized to evaluate the impact of a modified vigilance matrix and standardized utilization ratio (SUR) before and after its implementation. The matrix involved daily review and visual inspections of central lines by an infection preventionist, enabling real-time intervention, review of line necessity, and an active collaboration with medical providers to document potential secondary sources of infection within the infection window period.

Results: CLABSI occurrences plummeted from 4 to 0 during the intervention. The pre/post intervention t-test for CLABSI Vigilance Matrix compliance rate in the ICU significantly increased from an average of 53% pre-intervention to 73% post-intervention (p < .025). The pre-intervention period ranged from Q1 2021 through Q4 2022 and the post-intervention ranged from Q1 2023 till Q3 2023. Remarkably, there was a significant reduction in SUR for ICU CLABSI data (p < .011). However, no significant variances were noted in pre/post intervention comparisons for CLABSI infection counts from the ICU (p < .385).

Conclusions: The intervention sparked a significant surge in the prevention bundle compliance rate and significant reduction in SUR for the ICU unit. These outcomes underscore the effectiveness of the modified CLABSI Vigilance Matrix, highlighting the ongoing necessity to enhance compliance with preventive measures in critical care settings with a touch of collaboration and a sense of proactiveness.
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