Bloodstream infections are usually serious infections that typically increase hospital stays, risk of mortality, and cost of care. An estimated 248,000 bloodstream infections occur in U.S. hospitals each year. It is believed that a large portion of these infections are associated with the presence of a central line, i.e., central vascular catheter. The target-setting method is consistent with the DHHS Action Plan to Prevent Healthcare-Associated Infections goals. The suggested goal is 75% reduction of HAI infections by year 2020.
The Healthy People 2010 data source [National Nosocomial Infections Surveillance System (NNIS), CDC] has been retained. However, this system has evolved and is now the National Healthcare Safety Network (NHSN). The system is national in scope and currently supports more than 2,000 hospitals across the country. As of March 2010, twenty-one of the fifty states require hospitals to report healthcare-associated infection data through NHSN.
The predicted number of CLABSI are obtained by multiplying the CLABSI incidence rates for the 2006-2008 (baseline) period by the corresponding central line-days by patient care location. These estimates are summed to obtain the total which is the denominator of this measure.
A three-year baseline was chosen to increase the precision of the single point estimate. There were few facilities (about 300) reporting in 2006; by 2008, the number of reporting facilities had doubled (about 600). Including all three years in the baseline increased the precision of the referent period. The number of reporting units varies by year depending on state mandates and/or federal policy. Because of CMS reporting incentives, the number of facilities reporting CLABSI related to this measure is likely to stabilize after 2012 when approximately 5,000 hospitals will be reporting some CLABSI data. However, the number of reporting hospitals may continue to vary year to year.