Highlights
- •Ambulatory CLABSIs are not regularly tracked in complex ambulatory populations.
- •We developed an institutional workflow to identify and track outpatient CLABSIs.
- •We defined surveillance criteria including based on standard NHSN definitions.
- •This is a novel approach to attribute infections by lead and supporting divisions.
- •Our surveillance and attribution methods also incorporate home infusion patients.
Background
Central line-associated bloodstream infections (CLABSI) in ambulatory pediatric populations
are difficult to track at an institutional level, especially for complex patients
seen by multiple divisions and home health infusion agencies.
Methods
A multidisciplinary team comprised of key stakeholders from divisions with the most
patients discharged with a central line utilized Lean Six Sigma methodology of Define-Measure-Analyze-Design-Verify
(DMADV) to create a standardized data collection process for all ambulatory CLABSIs
and infection event reviews.
Results
A surveillance workflow was created to track, identify, and confirm ambulatory CLABSIs
in all patients with an indwelling central line. Defined surveillance criteria included
scope of patients eligible for ambulatory CLABSI surveillance, numerator definitions,
and denominator calculations. Additionally, a novel attribution method was created
for ambulatory CLABSIs in complex patient populations shared among multiple divisions
and home care infusion services.
Conclusions
This report is a novel institutional approach to accurately surveil, attribute, and
calculate ambulatory CLABSI data in a pediatric healthcare system.
Key Words
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Article info
Publication history
Published online: June 16, 2022
Footnotes
Conflict of interest: None to report.
Identification
Copyright
© 2022 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.
