Central Line Associated Blood Stream Infections

Central Line Associated Blood Stream Infections

Healthcare-Associated Central Line Blood Stream Infections in Intensive Care Units (ICUs)

What are Central Line Infections?
For certain patients requiring administration of a large amount of fluids and medications, an intravenous is not always sufficient to meet their care needs.  These patients require the insertion of a “central line” which provides direct access to the circulatory system. 

Why is this important?
Since the central line is inserted directly into a major blood vessel, it allows for quick delivery of fluids and/or medications. Patients in Intensive Care Units (ICUs) may have a central line placed if they need fluids, medications, or monitoring. Central lines are very helpful but sometimes they become infected.

Central lines are vulnerable to infection from all of the environmental factors which surround a patient from the moment the insertion takes place.  For example, when a central line is inserted, a small cut is made in the skin. Germs already on a patient’s skin can enter that small cut and cause an infection. Bags of fluid, drug containers, pressure-measuring devices and other tubes are connected to central lines; germs can also enter the tubes of a central line system if connections aren’t kept closed and properly disinfected, or if a device or drug put into the tubing isn’t sterile.

Hospital staff, patients, and visitors should be sure to follow current infection control guidelines for central lines. When everyone follows those guidelines, these infections became very rare even in ICUs where the risk of infection is higher than anywhere else in a hospital. (Washington State Department of Health).  If this type of line becomes infected, the infection may flow into the bloodstream. This type of infection can be very serious because it can lead to damage of other vital organs.

What are we measuring?
The number of patients with healthcare-associated central line bloodstream infections in intensive care units.  The ultimate goal is to eliminate central line infections.

Note: Hospitals use different ways to calculate rates. Saint Raphael’s calculates its rates using 1,000 patient days as the denominator.

What is our performance telling us?
The chart below
shows how the Hospital of Saint Raphael’s performance compares to a benchmark – data from the National Healthcare Safety Network. A big difference in the rates is meaningful. Small differences may not be statistically significant.

Saint Raphael’s central line infection rate is 1.25 per 1,000 patient days including all  intensive care units (ICUs) combined for the 2nd Quarter of the fiscal year (January thru March 2010). While our performance continues to improve, we won’t be satisfied until we reach our goal of zero preventable healthcare-associated blood stream infections.

What are we doing to improve our performance?
At Saint Raphael’s, we’re working to reduce the risk of these infections by providing a special insertion kit, standardizing the insertion and care of central lines, and providing ongoing surveillance of central lines. We review every healthcare-associated bloodstream infection that occurs to determine its cause so corrective measures can be taken that may prevent future infections.

The Standardized Infection Ratio (SIR) is a summary measure that is used to compare the number of actual central line associated bloodstream infections in a particular type of ICU against the national average of central line associated bloodstream infections for the same that type of ICU.   

NOTE:  Q4 FY10 – refers to the fourth quarter of the fiscal year – July thru September 2010

Infections Saint Raphael’s Performance
Q4 FY10  
Comparison:  National Healthcare
Safety Network

Overall Central Line-Associated
Blood Stream Infections in all ICUs

Number of Central Line-Associated Blood Stream Infections/1,000 cathter days
A lower score is better.

 2.40/1,000 catheter days  2.0



Page last updated on Oct. 22, 2010