In the quest to prevent central line-associated bloodstream infections (CLABSI), a nationally representative survey has shed light on the predominant usage of evidence-based technical interventions. However, there remains a substantial gap in employing behavioral interventions, implying a pressing need to address this imbalance. The study was initiated with the aim to gain a deeper understanding of the uptake of technical, behavioral, and leadership practices formulated to curb CLABSI. According to Dr. Larissa Pisney, MD, Medical Director of Infection Prevention and Control at the University of Colorado Hospital and UCHealth Denver Metro, recent data indicate an increase in CLABSI, catheter-associated urinary tract infections, ventilator-associated events, and methicillin-resistant Staphylococcus aureus bacteremia in 2021 compared to 2019.
Several pandemic-induced factors including enhanced patient acuity and staffing deficits, have likely been critical contributors to this increment. To navigate the post-pandemic scenario and better implement infection prevention strategies, Pisney and colleagues deployed surveys across 881 U.S. acute care hospitals. This aimed to evaluate the deployment of behavioral and technical interventions in CLABSI prevention. Survey findings revealed a high prevalence of technical interventions in surveyed facilities, including maximal sterile barriers and the usage of chlorhexidine gluconate-containing dressings. However, practices such as chlorhexidine gluconate bathing were less frequently followed, particularly in non-ICU settings.
Despite widespread usage of systems to monitor CLABSI, feedback to healthcare providers and the deployment of tools to ascertain the appropriateness of central venous catheters was reported less frequently. It was also observed that only a small percentage of respondents reported strategies to minimize routine blood cultures. These findings underscore the need for enhanced focus on incorporating behavioral and socio-adaptive strategies in CLABSI prevention, while continuing to uphold evidence-based technical interventions. Dr. Pisney emphasizes the importance of integrating automated tools into electronic health records, in lieu of solely relying on education on best practices. As hospitals grapple with staffing challenges in the post-pandemic landscape, the role of infection preventionists in liaising closely with hospital leadership to ensure resource allocation to bridge these gaps has become pivotal.