1066. The Impact of 2013 National Health Safety Network (NHSN) Definition Changes on Hospital Central-Line Associated Bloodstream Infection (CLABSI) Rates
Session: Poster Abstract Session: Surveillance of HAIs: Evaluating National Strategy
Friday, October 4, 2013
Room: The Moscone Center: Poster Hall C
Posters
  • 1066_IDWPOSTER.pdf (302.3 kB)
  • Background: NHSN, the nation’s most widely used healthcare-associated infection (HAI) tracking system, provides surveillance definitions for CLABSI to healthcare facilities in order to establish infection rates for benchmarking purposes. Recent discussion has centered around the Heme/Onc population as many CLABSI’s attributed to these patients may actually be due to translocation of intestinal or oral flora from mucosal barrier injury (MBI).  To address this issue, healthcare facilities reporting data to NHSN began using revised definitions for CLABSI in January 2013 that includes a more specific category for bloodstream infections (BSI) associated with MBI.

    Objective: To apply the revised 2013 NHSN CLABSI definitions to CLABSI’s from 2012 to demonstrate the impact of a definition change on CLABSI rates.

    Methods: CLABSI’s previously reported to NHSN from 2012 were obtained from existing infection control databases and analyzed using the new definitions.

    Results: The number of CLABSI’s decreased in 2012 from 74 to 56 by using the new 2013 definitions.  The NICU, Med/Surg, and Heme/Onc units had a decrease in CLABSI rates of 7%, 16%, and 45%, respectively.

    Table 1: CLABSI rates in 2012 based on revised 2013 definitions.

    Location

    2012 Line days

    # CLABSI reported in 2012

    2012 reported CLABSI rate/1000 line days

    # CLASBI in 2012 based on 2013 definitions

    # BSI in 2012 meeting new 2013 MBI definition

    # BSI  in 2012 not meeting 2013 criteria *

    2012 CLABSI rate/1000 line days based on 2013 definitions

    NICU

    8023

    15

    1.87

    14

    0

    1

    1.74

    PICU

    5625

    14

    2.49

    14

    0

    0

    2.49

    Heme/Onc

    5958

    33

    5.54

    18

    14

    1

    3.02

    Med/Surg

    7211

    12

    1.66

    10

    1

    1

    1.39

    Total

    26817

    74

    2.76

    56

    15

    3

    2.10

    *Did not meet criteria due to new 2 day calendar rule.

    Conclusion: In our 354 bed free-standing pediatric hospital applying the 2013 definitions to evaluate BSI’s from 2012 decreased our hospital’s overall 2012 CLABSI rate by 24%. Addition of the MBI category had a significant decrease in the number of primary CLABSI attributed to Heme/Onc patients thus potentially reflecting a more accurate CLABSI rate in this population. With implementation of the new definitions, institutions may see a decrease in their infection rates based on definition changes alone, making it difficult to assess the impact of quality improvement efforts.

    Yolanda Ballam, BS, CIC, Infection Prevention and Control, Children's Mercy Hospitals and Clinics, Kansas City, MO, Christelle Ilboudo, MD, Infectious Diseases, Children's Mercy Hospital and Clinics, Kansas city, MO and Robyn A Livingston, MD, Children's Mercy Hospital & Clinics, Kansas City, MO

    Disclosures:

    Y. Ballam, None

    C. Ilboudo, None

    R. A. Livingston, None

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