Central Line-associated Bloodstream Infection
October 2023 to December 2023
How is this measured?
Infection prevention and control staff look for new cases of CLABSI for patients in the intensive care units. Using a standard definition for CLABSI, the staff count up the number of patients who develop a CLABSI. They also count how many days all patients have a central line in the ICU. The CLABSI rate is calculated by dividing the number of patients who have a CLABSI observed in the ICU by the number of central line days each reporting period. The rate is calculated by 1000 line days.
The CLABSI rate is calculated as follows:
| CLABSI rate = | Number of CLABSIs | X 1,000 |
| Number of central line days |
What is a central line?
A central line is fed through a vein and provides access to major blood vessels (e.g. aorta, pulmonary artery). A typical intravenous line or IV is not considered a central line. Central lines are inserted through artificial openings in the skin, which decreases the ability of the body to keep out bacteria.
What is a central line-associated bloodstream infection?
A central line-associated bloodstream infection or CLABSI occurs when bacteria get into the line and spreads to the bloodstream causing infection.
Why is this important?
Measuring, monitoring and reporting CLABSI rates in ICU can assist hospitals with evaluating the effectiveness of their infection prevention and control interventions and make further improvements based on this information.
What should the rate of CLABSI be?
It would be best to have no infections, however it may not be possible to prevent all bloodstream infections in patients with central lines. Infection rates can vary from different types of ICUs, hospital to hospital, and from month to month. Rates may be different based on the types of ICUs, the types of services they provide, the patients they serve, and the frequency of central line use. The rates provided here are not meant for hospitals to compare themselves against each other, or for the public to use to decide where they should get health care.
A benchmark provides a standard rate or "average" of infection. We can use this benchmark to see if our rates are above or below this average. The Canadian Nosocomial Infection Surveillance Program national benchmarks are as follows:
| Adult Intensive Care Units (all) | 1.20 |
| Pediatric Intensive Care Unit | 1.33 |
| Neonatal Intensive Care Unit | 1.90 |
What can patients and families do to help?
- Ask lots of questions. Find out why you need the line and where it will be placed. Learn what steps the hospital is taking to reduce the risk of infection.
- Try not to touch your central line or dressing.
- Practice good hand hygiene. Ask your family, friends and visitors to clean their hands frequently.
- Make sure care providers, such as doctors and nurses, clean their hands with soap and water or an alcohol-based hand rub before and after caring for you or your loved ones.
Protocol
Read the Protocol for CLABSI Surveillance in ICUs.