Catheter Safeguards Reduce Hospital Infections

Quality improvement (QI) interventions designed to prevent bloodstream infections related to central venous catheters (CVCs) save lives and hospital expenditure, according to a new study.

Researchers at Cedars-Sinai Medical Center, the RAND Corporation, and other institutions conducted a systematic review of economic evaluations of QI interventions designed to prevent bloodstream infections in acute care hospitals, and which reported program and infection-related costs. For each study, the researchers performed a cost-consequences analysis from the hospital perspective, estimating the incidence rate ratio (IRR) and incremental net savings.

The results, gleaned from data published in the last decade on catheter-related bloodstream infections at 113 hospitals, show that safety interventions, on average, reduced the infection rate by 57% at these hospitals, while producing net savings of USD 1.85 million for each site over three years. For every USD 100,000 spent by the hospital, it realized an average USD 315,000 in savings because it treated fewer infected patients. The average cost of implementing such a program was USD 270,000 for each site. The study was published in the December 2016 issue of JAMA Internal Medicine.

“Due to the high cost of caring for patients when central-line infections develop, even sizable up-front investments in infection prevention can be associated with large net savings,” said Teryl Nuckols, MD, MSHS, director of the division of general internal medicine in the Cedars-Sinai department of medicine. “On the basis of our findings, hospitals that have not yet achieved very low rates of infection can consider implementing a variety of safety practices.”

Central–line-associated bloodstream infections (CLABSI) and catheter-related bloodstream infections (CRBSI) are linked to more than 60,000 primary bloodstream infections each year in the United States alone, with an estimated fatality rate of 12% or more. Hospitals in recent years have thus introduced safety procedures that contain checklists for attending staff that include donning sterile gloves, covering catheters with antimicrobial dressings, and checking catheters daily for signs of movement or infection. Many hospitals also have invested in extra training, equipment, and supplies to improve safety.