Central Line Associated Blood-Stream Infection (CLA-BSI) rate: Difference between revisions

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Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital
===QI domain===
===QI domain===
*[[QualityDomain::Safe]]
*[[QualityDomain::Safe]]
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==Sampling Plan / Procedure==
==Sampling Plan / Procedure==
*100% for all patients with one or more central lines (CL) as indicated by the presence of {{TISS w Nr | Central Venous Catheter at 2300 (TISS Item)}}
*100% for all patients with one or more [[Central Line]]s (CL) as indicated by the presence of {{TISS w Nr | Central Venous Catheter at 2300 (TISS Item)}}
{{Discuss | who=Julie | question=
** Starting Oct 1, 2020, the  {{TISS w Nr | 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 {{TISS w Nr | Central venous catheter (TISS Item)}} is marked, then the patient is assumed to have CVC at 2300 hour.
**A central lines (CL) is a central venous catheters (CVC) that terminates at or close to the heart or one of the great vessels. Great vessels include the pulmonary artery, superior vena cava, inferior vena cava, brachiocephalic, internal jugular, subclavian, external iliac and the common femoral veins.
** See [[Central Line]] for a definition.
*** Could we link to [[Central Line]] for details instead so that if we change any they will remain consistent? }}
*100% sampling for all cases with CLA-BSI incidence following the criteria listed in [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) | CLA-BSI]]
*100% sampling for all cases with CLA-BSI incidence following the criteria listed in [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI) | CLA-BSI]]


===Inclusion Criteria===
===Definition===
CVCs include percutaneous non-tunnelled, tunnelled (e.g. Hickman), peripherally inserted (PICC) and pulmonary artery catheters.
The definition follows the definition [[Central Line]].  
===Exclusion Criteria===
 
This does not include totally implanted devices (e.g. Ports), arterial catheters, pacemaker leads and other non-infusion devices.
===Frequency===
===Frequency===
* Recording the date the [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)| CLA-BSI]] occurred.
* Recording the date the [[Iatrogenic, infection, central venous catheter-related bloodstream infection (CVC-BSI, CLI)| CLA-BSI]] occurred.
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===Denominator===
===Denominator===
Total Number of Central Line days at 2300 HR of a reporting period
Total Number of Central Line days at 2300 HR of a reporting period
===Formula===
CLA_BSI Rate Rate = Num / Denom * 1000
==Data Sources==
==Data Sources==
* Starting 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.
* CLA_BSI
** Before 2019,  the dates when CLA-BSI  occurred were taken from the Tmp project [[QA Infection]].
** 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.
* Central Line (CVC) days are taken from TISS28 item#46 [[Central Venous Catheter at 2300 (TISS Item)]]
** 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==
==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 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\CFE_tiss28.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==
==Report Users==

Latest revision as of 18:26, 2022 January 7

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

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

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

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