A central line-associated bloodstream infection (CLABSI) is a laboratory-confirmed primary bloodstream infection (LCBI) where central line (CL) or umbilical catheter (UC) was in place for >2 calendar days on the date of event, with day of device placement being Day 1, AND a CL or UC was in place on the date of event or the day before. If a CL or UC was in place for >2 calendar days and then removed, the date of the event of the LCBI must be the day of device discontinuation or the next day. If the patient is admitted or transferred into a facility with an implanted central line (port) in place, and that is the patient's only central line, day of first access as an inpatient is considered. 8
Laboratory-confirmed bloodstream infections
Criterion 1:
Patient has a recognized pathogen cultured from one or more blood cultures and organism cultured from blood is not related to an infection at another site. 8
Criterion 2:
Patient has at least one of the following signs or symptoms: fever (greater than 38°C [100.4°F]), chills, or hypotension and signs and symptoms and positive laboratory results are not related to an infection at another site and common commensal is cultured from two or more blood cultures drawn on separate occasions. 8
Criterion 3:
Patient less than 1 year of age has at least one of the following signs or symptoms: fever (greater than 38°C [100.4°F] core), hypothermia (36°C [86°F] core), apnea, or bradycardia and signs and symptoms and positive laboratory results are not related to an infection at another site and common skin commensal is cultured from two or more blood cultures drawn on separate occasions. 8
Ceballos, K., Waterman, K., Hulett, T., & Makic, M. F. (2013). Nurse-driven quality improvement interventions to reduce hospital acquired infection in the NICU [Continuing Education]. Advances in Neonatal Care, 13(3), 154-163. http://dx.doi.org/10.1097/ANC.0b013e318285fe70
Doellman, D. (2012, Fall). The litigation environment for central line-associated bloodstream infections: Hospitals face greater risk when they fail to follow standards of care. Journal of Legal Nurse Consulting, 24(2), 31-34. Retrieved from http://www.aalnc.org
Jeong, I. S., Park, S. M., Lee, J. M., Song, J. Y., & Lee, S. J. (2013, February 5). Effect of central line bundle on central line-associated bloodstream infections in intensive care units. American Journal of Infection Control, 41(8), 710-716. http://dx.doi.org/10.1016/j.ajic.2012.10.010
O’Grady, N. P., Alexander, M., Burns, L. A., Dellinger, E. P., Garland, J., Heard, S. O., ... Saint, S. (2011). Guidelines for the prevention of intravascular catheter-related infections. Retrieved from http://www.cdc.gov/hicpac/BSI/BSI-guidelines-2011.html
Williams, D. W. (2015, January/February). Use of a policy-driven education program to reduce central line-associated bloodstream infection rates. Journal of Infusion Nursing, 38(1), 63-68. http://dx.doi.org/10.1097/NAN.0000000000000076
How-to Guide: Prevent Central Line-Associated Bloodstream Infections (CLABSI). Cambridge, MA: Institute for Healthcare Improvement; 2012. (Available at www.ihi.org)
Adapted from US Centers for Disease Control and Prevention. National Healthcare Safety Network. DeviceAssociated (DA) Module. Protocol and Instructions: Central Line– Associated Bloodstream Infections (CLABSI) Event. Jan 2012. Accessed Mar 20, 2012. http://www.cdc.gov/nhsn/PDFs /pscManual/4PSC_CLABScurrent.pdf.