Central Line Infections
Patients often need to be given medicines or fluids or to have blood samples, collected while in the hospital. Sometimes caregivers use a central line or catheter for this purpose.
A central line is a tube put into a large vein, usually in the neck, chest, arm or groin. It may need to be in place for several weeks. The risk of infection increases with the increased duration of time a central line is used.
If bacteria or other germs get into a central line, they can enter the bloodstream and cause an infection. Signs of such an infection may include fevers and chills. Sometimes the area around the tube insertion point becomes red or sore.
Though these types of infections are serious, they are often treated successfully with antibiotics and removal of the central line.
Hospital staff at Cedars-Sinai take many precautions to prevent bloodstream infections associated with central lines, including:
- Choosing the best location for putting in a central line
- Properly cleaning hands before putting in the central line
- Wearing a mask, cap, sterile gown and sterile gloves when putting in a central line
- Covering the patient with a sterile sheet
- Properly cleaning the patient's skin before putting the line in
- Properly cleaning the hands, wearing sterile gloves and cleaning the catheter opening before using the central line to give medicines or draw blood
- Carefully handling medicines and fluids administered through the central line
- Properly cleaning the hands and wearing sterile gloves when changing the bandage that covers the area where the catheter enters the skin
- Removing the central line when it is no longer needed
By carefully monitoring the rate of central line infections, Cedars-Sinai lives up to its commitment to improving the quality of care for patients.
As a legal requirement, California hospitals report these infections to the California Department of Public Health and the National Healthcare Safety Network, part of the Centers for Disease Control and Prevention. The California department adjusts the data for risk factors according to the federal network's protocols. The risk adjustment is required, and uses national data to compare the actual number of infections to the expected number, based on the age and health of the surgery patients.
The chart below shows the rate of central line-linked bloodstream infections that occurred in patients at Cedars-Sinai vs. the expected number.
What Is the Standardized Infection Ratio?
The standardized infection ratio is a summary measure used to track infections at a national, state or local level over time. The ratio compares the actual number of infections reported to a predicted number, adjusting for risk factors significantly associated with differences in infection incidence. A lower number is better.
Impact on Standardized Infection Ratios After 2015 Rebaselining
The National Healthcare Safety Network instituted the new 2015 baseline time period for the number predicted calculation. The data included in the 2015 baseline will serve as a new reference point for comparing progress. CDC expects that hospital standardized infection ratios will increase and shift closer to one. This shift reflects nationwide improvement in infection prevention from the previous baseline time period.