Eliminating CLABSI, A National Patient Safety Imperative: Neonatal CLABSI Prevention
The impact of the intervention was assessed by estimating the number of infections prevented, lives saved, and excess costs averted. To estimate the number of central line-associated bloodstream infections (CLABSIs) prevented, the number of actual CLABSIs reported are compared with the number of CLABSIs that would have occurred if the pre-intervention ("baseline") rate of CLABSIs per 1,000 line days had persisted (Equation 1). These calculations were done on a monthly basis and totaled between January and August 2012. To estimate the deaths prevented, a range in mortality was assumed (11-31 percent)2. Thus, for each 100 CLABSIs prevented, 11-31 deaths are prevented.
# CLABSIs Prevented = (Baseline Rate-Observed Rate) x (# Line Days)
Table 9 illustrates the estimated CLABSIs prevented to date. In total, an estimated 131 infections were prevented over the course of the study which translates to an estimated 14-41 deaths prevented. In a 2012 study by Donovan et al.3, $16,800 in excess costs were attributed to NICU-associated bloodstream infection. As such, preventing 131 infections is equivalent to $2,201,776 in excess costs averted. These estimates only consider data currently available and as such do not include infections avoided, deaths prevented, and excess costs averted projected forward.
|Total Central Line Days
|CLABSI Rate Per Thousand Line Days||2.043||0.988||0.703||1.354||0.986||1.125||1.156||1.103||0.855|
|CLABSIs at Baseline CLABSI Rate
(Baseline Rate x days/1000)
|CLABSIs Prevented (CLABSIs at Baseline Rate—CLABSIs at Quarterly Rate)*||16||21||12||19||18||15||15||14|
2. Powers, RJ & Wirtschafter, DW (2010). Decreasing central line associated bloodstream infection in neonatal intensive care. Clinics in Perinatology 37(1), 247-272.
3. Donovan EF, et al. (2012). The investment case for preventing NICU-associated infections. American Journal of Perinatology [in press].