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Survey of Central Line–Associated Bloodstream Infection Prevention Practices across American Burn Association–Certified Adult Burn Units

Published online by Cambridge University Press:  02 January 2015

Geetika Sood ,
Doris Heath ,
Kerri Adams ,
Charlotte Radu ,
Judy Bauernfeind ,
Leigh Ann Price  and
Jonathan Zenilman
Geetika Sood*
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Doris Heath
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Kerri Adams
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Charlotte Radu
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Judy Bauernfeind
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Leigh Ann Price
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
Jonathan Zenilman
Affiliation:
Division of Infectious Diseases, Johns Hopkins Bayview Medical Center, Baltimore, Maryland
*
Johns Hopkins Bayview Medical Center, 5200 Eastern Avenue, Baltimore, MD 21224 ([email protected])
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Extract

Central line–associated bloodstream infections (CLABSIs) have a considerable impact on morbidity, length of stay, and potential mortality. The estimated per-case cost of CLABSIs is $11,000–$56,167, and there is consensus that most are preventable. Publicly reported CLABSI data are also now used as a metric to compare hospitals.

There are published guidelines for the prevention of central line–associated infections, but these practices have not been studied in burn patients. Patients with severe burns pose unique and specific challenges and differ substantially from the typical medical or surgical intensive care unit (ICU) patient. Our objective was to assess CLABSI prevention practices in burn units.

We identified all American Burn Association (ABA)–certified adult burn centers through the ABA website (http://www.ameriburn.org) and contacted nursing leadership of each burn intensive care unit to conduct a telephone survey of CLABSI prevention practices in March 2012. The survey project was approved by the Johns Hopkins institutional review board.

We had 100% survey participation. There was substantial variation among burn units in the number of beds, the mix of patients, and the acuity of patients' illness. Bed size varied from 4 to 38. Eight units stated that their burn unit incorporated a step-down unit or floor-status beds in their bed count. Thirty (58.8%) of the 51 units defined themselves as mixed burn/surgical or trauma units. The percentage of burned patients seen in the burn units varied from 10% to 100%, with 8 (15.4%) of 51 units stating that their census consisted of fewer than 30% burned patients in their burn ICU.

Type
Research Briefs
Information
Infection Control & Hospital Epidemiology , Volume 34 , Issue 4 , April 2013 , pp. 439 - 440
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2013

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References

1.Blot, SI, Depuydt, P, Annemans, L, et al.Clinical and economic outcomes in critically ill patients with nosocomial catheter-related bloodstream infections. Clin Infect Dis 2005;41(11):1591–1598.Google Scholar
2.Januel, J-M, Harbarth, S, Allard, R, et al.Estimating attributable mortality due to nosocomial infections acquired in intensive care units. Infect Control Hosp Epidemiol 2010;31(4):388–394.Google Scholar
3.Pittet, D, Tarara, D, Wenzel, RP. Nosocomial bloodstream infection in critically ill patients: excess length of stay, extra costs, and attributable mortality. JAMA 1994;271(20):1598–1601.CrossRefGoogle ScholarPubMed
4.Warren, DK, Quadir, WW, Hollenbeak, CS, Elward, AM, Cox, MJ, Fraser, VJ. Attributable cost of catheter-associated bloodstream infections among intensive care patients in a nonteaching hospital. Crit Care Med 2006;34(8):2084–2089.Google Scholar
5.Harbarth, S, Sax, H, Gastmeier, P. The preventable proportion of nosocomial infections: an overview of published reports. J Hosp Infect 2003;54(4):258–266.Google Scholar
6.Berenholtz, SM, Pronovost, PJ, Lipsett, PA, et al.Eliminating catheter-related bloodstream infections in the intensive care unit. Crit Care Med 2004;32(10):2014–2020.Google Scholar
7.Pronovost, P, Needham, D, Berenholtz, S, et al.An intervention to decrease catheter-related bloodstream infections in the ICU. N Engl J Med 2006;355(26):2725–2732.Google Scholar
8.O'Grady, NP, Alexander, M, Burns, LA, et al. Guidelines for the prevention of intravascular catheter-related infections. Centers for Disease Control and Prevention, http://www.cdc.gov/hicpac/pdf/guidelines/bsi-guidelines-2011.pdf. Published April 1, 2011.Google Scholar
9.O'Mara, MS, Reed, NL, Palmieri, TL, Greenhalgh, DG. Central venous catheter infections in bur n patients with scheduled catheter exchange and replacement. J Surg Res 2007;142(2):341–350.CrossRefGoogle Scholar
10.King, B, Schulman, CI, Pepe, A, Pappas, P, Varas, R, Namias, N. Timing of central venous catheter exchange and frequency of bacteremia in bur n patients. J Burn Care Res 2007;28(6):859–860.Google Scholar