A central line, also called a central venous line or a central venous catheter, is a catheter that is passed through a vein to end up in the vena cava (the large vein returing blood to the heart). These lines are inserted in those patients who require long or short term venous access for the admistration of medications and fluids, monitoring of special blood pressures and for long term dialysis and chemotherapy patients. Central lines are often placed in patients who require care in the Intensive Care Unit (ICU) as they are seriously ill and require many medications and monitoring activities.
A central line bloodstream infection can occur when bacteria enters the blood stream while the central line is in place. The bacteria can come from the patient's own skin flora, the environment and via the hands of health care providers.
Iinterventions for the placement and care of central lines at Orillia Soldier's Memorial Hospital are evidence based, best practices and include:
- Hand Hygiene
- Maximal Barrier Precautions
- Appropriate Skin Antisepsis
- Optimal Catheter Site Selection
Beginning in April 2009, all hospitals with an Intensive Care Unit (ICU) are required to report quarterly, their rates of central line infections in the ICU population. The CLI rate is calculated as follows:
Number of nosocomial patients with laboratory identification of MRSA bacteraemia x 1000
Total number of patient daysWhy focus on CLI-BSI?
OSMH Rates of CLI are presented below:
| Central Line Infection Rate – Adult ICU |
| | 2008/09 Fiscal Year | 2009/2010 Fiscal Year |
| | 4th Quarter | Apr-June | July-Sept | Oct-Dec | Jan-Mar |
| OSMH Acquired | 0 | | | | |
| Line Days | | | | | |
| OSMH Rate/1000 Line Days | 0 | | | | |
| Provincial Rate/1000 Line Days | N/A* | | | | |
*Data not available
The public reporting of our CLI rates is not intended to serve as a measure for hospitals to compare themselves against other organizations, or for the public to use as a measure of where to seek care. The analysis of our CLI rates over time will certainly provide us with helpful information that we can use to make quality improvements in our organization.
Public reporting of our hospital’s CLI rates will allow Orillia Soldiers' Memorial Hospital to establish a baseline from which we can then track our rates over time. If we feel our rates have risen above our baseline, we can look internally at our hospital’s processes, identify areas for improvement, and implement strategies to reduce the incidence of these infections at OSMH.