CLABSI Reductions Saved $1.8B in Healthcare Costs, Says CDC

Proving that dreaded hospital central line bloodstream infections (CLABSI) can be reduced, a federal report shows a decline in intensive care unit bloodstream infections of 58% in 2009 compared with 2001.

"Preventing bloodstream infections is not only possible, it should be expected," said Thomas R. Frieden, MD, director of the Centers for Disease Control and Prevention, which released the new statistics.

"Meticulous insertion and care of the central line by all members of the clinical care team, including doctors, nurses, and others at the bedside is essential. The next step is to apply what we've learned from this to other healthcare settings and other healthcare-associated conditions, so that all patients are protected," he said.
But these kinds of infections are still occurring, according to the CDC report. In 2009, central line infections occurred 60,000 times in patients treated in healthcare settings outside the ICU, such as hospital wards and kidney dialysis clinics. About 23,000 of these occurred in non-ICU patients in 2009 and in 2008, about 37,000 infections occurred in dialysis clinic patients.

The report, published in a monthly publication from the CDC called "Vital Signs," says that during the nine years, improvements in care translated to about $1.8 billion in healthcare cost savings. Also, 27,000 patients who would have died of their infections survived.

In 2009 alone, efforts to reduce infections saved 3,000 to 6,000 lives and about $144 million in extra medical costs compared with 2001.

Denise Cardo, MD, director of the CDC's Division of Healthcare Quality Promotion, credited the reduction to hospital, local, state, and national medical and public health efforts that track infection rates and then use that information to tailor prevention efforts.
"The report findings point to a clear need for action beyond ICUs.  Fortunately, we have a prevention model focused on full collaboration that can be applied broadly to maximize prevention efforts."

The CDC suggests five efforts to continue the reduction in CLABSI:

1. Providers should be on the lookout to be aware of and make sure healthcare providers follow infection control guidelines when a central line is inserted and used.
2. Hospital and other staff in healthcare settings to "speak up when guidelines aren't followed."
3. Track infection rates and germ types with the CDC's National Healthcare Safety Network to learn where and why infections are happening, target actions to stop them and track progress.
4. Recognize staff members or units that work hard to prevent these infections or that solve infection control issues.
5. Join state-based prevention programs such as the Agency for Healthcare Research and Quality's expansion of "On the CUSP: Stop BSIs."

A major effort is in preventing infections in people who receive kidney dialysis, which about 350,000 people in the U.S. undergo at any given time. About eight in 10 receive treatment through a central line.  Infections are one of the major reasons for the high death and hospitalization rates for patients undergoing hemodialysis, with 37,000 infections in this population alone in 2008. Compounding the problem is that these infections are more likely to be resistant to the most effective and common types of antibiotics.

President and CEO of the American Hospital Association Rich Umbdenstock said patients and hospitals "welcome news that confirms that hospitals are making tremendous progress in reducing certain infections."

He adds, however, that "We will not rest until healthcare associated infections are totally eliminated, and we applaud the work of hospitals, doctors, nurses and other staff in making hospitals safer than ever before."

But he blasted proposed recently passed federal regulations that would "penalize 25% of all hospitals each year—those that report the highest proportion of hospital-associated condition, no mater how small that number may be—regardless of improvement."

Rather, he said, "we've learned that success comes from collaboration and promotion of best practices rather than through counterproductive policies."

The Association for Professionals in Infection Control and Epidemiology (APIC) released a statement on the CDC report saying the reduction "reflects a focus by direct care providers, in collaboration with infection preventionists, on improving patient safety and preventing this serious type of healthcare-associated infection (HAI)."

However, the association added, “Continued progress in preventing HAIs requires adequate resources dedicated to infection prevention and control programs. Healthcare institutions can replicate the CLABSI improvement efforts seen in ICUs by applying similar and equally rigorous prevention strategies and resources in other areas.

"Staff in outpatient settings, including hemodialysis centers, need resources and infection prevention education, in order for the most up-to-date, evidence-based measures to be applied on a consistent and sustained basis."

See Also:
CDC Says 18% Drop in Central Line Infections Is Just the Beginning
Nearly half of CA dialysis technicians failing skills test
Failure In Central Line Infection Prevention, Survey Says
Hospital Infection Reporting Standards Inconsistent
PICU Holds Off Central-Line Infections For Full Year