Central Line Associated Blood-Stream Infection (CLA-BSI) rate

CLA-BSI defined using CDC case definition.

Indicators
Indicator:	Central Line Associated Blood-Stream Infection (CLA-BSI) rate
Created/Raw:	Created
Program:	Critical Care
Start Date:
End Date:
Reports:	Directors Quarterly and Annual Report (Critical Care), STB ICUs VAP Rate, CLIBSI Rate Summary, WRHA ICU Hospital-Acquired Conditions

• Cargo

• SMW:

• Categories

• Default form:

Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital

QI domain

• Safe

Significance

CLA-BSIs increase morbidity, mortality and costs. It can be prevented using evidence-based interventions. This measure can be used to detect changes related to implementation or lack of adherence to these best practices.

Sampling Plan / Procedure

• 100% for all patients with one or more Central Lines (CL) as indicated by the presence of T - Central Venous Catheter at 2300 (TISS Item)
  • Starting Oct 1, 2020, the T - Central Venous Catheter at 2300 (TISS Item) is no longer collected . The presence of CVC at 2300 hour is imputed or assigned by inference using this method - if patient is present at 23HR and the T17 - Central venous catheter (TISS Item) is marked, then the patient is assumed to have CVC at 2300 hour.
  • See Central Line for a definition.
• 100% sampling for all cases with CLA-BSI incidence following the criteria listed in CLA-BSI

Definition

The definition follows the definition Central Line.

Frequency

• Recording the date the CLA-BSI occurred.
• Daily recording of dates patients have CL or CVC
• Total number of Central Line days are calculated and reported on a monthly, quarterly or yearly basis based on the daily data.
• Time Reference is calendar month, quarter or year.

Definition and Derivation

CLA-BSI per 1000 Central line days.

Numerator

Number of CLA-BSI incidence during the ICU stay of a reporting period

Denominator

Total Number of Central Line days at 2300 HR of a reporting period

Formula

CLA_BSI Rate Rate = Num / Denom * 1000

Data Sources

• CLA_BSI
  • Starting Jan 2019, CLA-BSI is part of the ICD10 collection with code T82.70 Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) under the Acquired Diagnosis / Complication. The date is the Dx Date of the Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) diagnosis.
  • Aug 2009 to Dec 2018, the dates when CLA-BSI occurred were taken from the Tmp project QA Infection.
• Central Line (CVC) days
  • Starting Oct 2020, Central Line (CVC) days are taken at CCI Collection Mode CCI collect each day
  • Jan 2013 to Sept 2020 Central Line (CVC) days are taken from TISS28 item#46 Central Venous Catheter at 2300 (TISS Item)
  • Apr 2008 to Dec 2012 Central Line (CVC) days are collected by CRN and data are saved at S:\MED\MED_CCMED\CCMDB_Special_Projects\Central_Line_Infections_ETube\DATA_ENTRY_LineCounts_ETube

SAS Program

• The SAS program to get the CLA_BSI is X:\Julie\SAS_CFE\CFE_macros\Pre_ICD10_AcqDx.sas
• The SAS program to get the Central line Days is X:\Julie\SAS_CFE\CFE_macros\Read_TISS76_TISS28_TISSinCCI.sas
  • macro %tisscci23hr shows the generation of Central Line (CVC) present at 23 HR
• The SAS program to get the CLA_BSI rate is X:\Julie\SAS_CFE\CFE_macros\VAPCLICAM.sas

Report Users

• Critical Care Directors, Critical Care Unit Managers and WRHA Outcome Improvement Team Committee
• St Boniface Cardiac Sciences Program (STB site only)
• HSC Infection Prevention & Control (HSC site only)
• WRHA Infection Prevention & Control