Electronic health record solutions to reduce central line-associated bloodstream infections by enhancing documentation of central line insertion practices, line days, and daily line necessity

Quan, Kathleen A.; Cousins, Sarah M.; Porter, Darlene D.; O'Brien, Margaret; Rudkin, Scott; Lambertson, Brian; Hoang, Dennis; Dangodara, Amish A.; Huang, Susan S.

doi:10.1016/j.ajic.2015.10.036

Cited by 23 publications

(14 citation statements)

References 6 publications

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“…Another previous study implemented an EHR checklist for central line insertion bundle elements and postinsertion verification of line necessity. 18 The EHR automatically generated a daily procedure note for the physician to fill out and gave relevant feedback on missing bundle elements. This intervention resulted in improved documentation compliance and quality of CLABSI tracking data.…”

Section: Discussionmentioning

confidence: 99%

Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream Infections

Chemparathy

Seneviratne

Ward

et al. 2021

Pediatric Quality &Amp; Safety

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Introduction: Central line-associated bloodstream infections (CLABSIs) are the most common hospital-acquired infection in pediatric patients. High adherence to the CLABSI bundle mitigates CLABSIs. At our institution, there did not exist a hospital-wide system to measure bundle-adherence. We developed an electronic dashboard to monitor CLABSI bundle-adherence across the hospital and in real time. Methods: Institutional stakeholders and areas of opportunity were identified through interviews and data analyses. We created a data pipeline to pull adherence data from twice-daily bundle checks and populate a dashboard in the electronic health record. The dashboard was developed to allow visualization of overall and individual element bundle-adherence across units. Monthly dashboard accesses and element-level bundle-adherence were recorded, and the nursing staff’s feedback about the dashboard was obtained. Results: Following deployment in September 2018, the dashboard was primarily accessed by quality improvement, clinical effectiveness and analytics, and infection prevention and control. Quality improvement and infection prevention and control specialists presented dashboard data at improvement meetings to inform unit-level accountability initiatives. All-element adherence across the hospital increased from 25% in September 2018 to 44% in December 2019, and average adherence to each bundle element increased between 2018 and 2019. Conclusions: CLABSI bundle-adherence, overall and by element, increased across the hospital following the deployment of a real-time electronic data dashboard. The dashboard enabled population-level surveillance of CLABSI bundle-adherence that informed bundle accountability initiatives. Data transparency enabled by electronic dashboards promises to be a useful tool for infectious disease control.

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Section: Discussionmentioning

confidence: 99%

Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream Infections

Chemparathy

Seneviratne

Ward

et al. 2021

Pediatric Quality &Amp; Safety

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“…We demonstrate that collecting whole hospital CLABSI data is achievable and provides valuable information for benchmarking and to direct targeted interventions. Electronic‐ and paper‐based methods with manual validation and auditing, with a multidisciplinary team to check CLABSI classification, ensure that robust datasets are established …”

Section: Discussionmentioning

confidence: 99%

“…Electronic-and paper-based methods with manual validation and auditing, with a multidisciplinary team to check CLABSI classification, ensure that robust datasets are established. 10 Future goals include sustainable methods that deliver accurate, internationally comparable, real-time, hospital-wide CLABSI rates. As occurs in some jurisdictions, we recommend mandatory surveillance, reporting and CLABSI definitions to be further tailored to children to encourage more paediatric hospitals to collect and report CLABSI data.…”

Section: Discussionmentioning

confidence: 99%

Lessons learned from a hospital‐wide review of blood stream infections for paediatric central line‐associated blood stream infection prevention

Campbell

Blyth

Hewison

et al. 2018

J Paediatrics Child Health

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Aim Bacteraemia episodes were assessed to calculate a hospital‐wide central line‐associated blood stream infection (CLABSI) rate per 1000 catheter‐days. Secondary objectives were to describe risk factors, microbiology and outcomes of children with CLABSI. Methods A retrospective study was conducted at an Australian tertiary paediatric hospital in children <18 years who had blood culture sampling during the 2‐year period, 2014–2015. All blood culture results were extracted from the hospital's laboratory information system. National Healthcare Safety Network Centres for Disease Control and Prevention definitions for bacteraemia classification were used. Central venous access device (CVAD) insertion and removal dates were obtained from a surgical electronic database and anaesthetic records and then manually validated. Results Of 11 774 processed blood culture bottles, 207 episodes of blood stream infection were observed. Eighty‐five (41%) episodes were community‐acquired bacteraemia (CA‐B) and 122 (59%) health care‐associated bacteraemia (HA‐B), of which 73 (35%) were CLABSI. The hospital‐wide CLABSI rate was 0.62 per 1000 catheter‐days (95% confidence interval: 0.49–0.77). Conditions associated with CLABSI were malignancy (n = 45, 62%) and gastrointestinal failure (n = 6, 8%). Thirty‐three (45%) CLABSI episodes developed in an outpatient setting. Conclusions HA‐B has a significant impact on child health, exceeding the number of CA‐B at our hospital. Children with CVADs are vulnerable in both the inpatient and outpatient settings. Collecting robust data for a hospital‐wide CLABSI rate is important to understand the full spectrum of paediatric CLABSI. The value of validating data using both electronic and manual methods is demonstrated.

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“…We have since shown that embedding CLIP elements into an electronic procedure note can markedly increase CLIP form submission. 6 …”

Section: Discussionmentioning

confidence: 99%

Marked reduction in compliance with central line insertion practices (CLIP) when accounting for missing CLIP data and incomplete line capture

Scott

Gohil

Quan

et al. 2016

American Journal of Infection Control

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Electronic health record solutions to reduce central line-associated bloodstream infections by enhancing documentation of central line insertion practices, line days, and daily line necessity

Cited by 23 publications

References 6 publications

Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream Infections

Development and Implementation of a Real-time Bundle-adherence Dashboard for Central Line-associated Bloodstream Infections

Lessons learned from a hospital‐wide review of blood stream infections for paediatric central line‐associated blood stream infection prevention

Marked reduction in compliance with central line insertion practices (CLIP) when accounting for missing CLIP data and incomplete line capture

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