from their analysis . I would expect a high burden of COVID on those units last year which would also have potentially had increases similar to what is reported for these other unit types .
HHM Do you think the shifts relating to people , product and process during the pandemic had an impact on CLABSI rates ?
MD : Most definitely .
HHM The ICHE paper notes “ high-acuity care for patients with COVID-19 posed heightened challenges for preventing device-associated infections .” Do you agree ? Will COVID-19 continue to impact CLABSI rates in 2021 ? Any other external factors that could impact rates this year ? Best advice for managing through this challenge ?
MD : I do agree . We were faced with so many unknowns about the disease during the time period of the study , plus staffing concerns , PPE shortages and various strategies to protect supply chain as well as staff safety . For areas that have
continued to see cases , I do believe the impact on CLABSI may persist . I also believe that with a year of tremendous pressure it will take a while to recover / return to our routine practices . I worry that some of the workarounds that arose because of necessity are going to take a lot of effort to “ undo .” Although we had a reprieve in CMS reporting and associated financial ramifications during the first half of 2020 , the programs resumed during the latter half of the year and are in place for 2021 . Our Value-Based Purchasing target is even lower than it was before the start of the pandemic , so there is much to be done to ensure our patients are achieving the safest possible care and best possible outcomes . There is an urgency to this goal . Additionally , for 2021 ECRI had identified harm from peripheral vascular access devices among its top 10 patient safety risks . Coupled with the newly updated 2021 Infusion Therapy Standards of Practice we have a strong road map for driving improvements across all devices . high-acuity care for patients with COVID-19 posed heightened challenges for preventing device-associated infections , CLABSIs — in critical-care locations — occurred relatively frequently in the 2020 data . The number of CLABSIs in those locations exceeded CLABSIs in ward locations by 1,100 events for the quarter ; in prior years , the number of CLABSIs identified in ward locations would typically exceed the number reported from ICUs . NHSN data do not enumerate the specific type of ICU location of patients with COVID-19 ; but among all ICUs , increases CLABSIs were highest in the medical-surgical critical-care units . The significant 59 percent increase in the 2020 SIR highlights the likely burden that was placed on these units .”
As Patel , et al . ( 2021 ) note , “ Infection control practices changed in many healthcare settings during the pandemic to accommodate increasing numbers of patients and to mitigate shortages of personal protective equipment , supplies , and staffing . Reducing the frequency of contacts with patients and of maintenance activities for central catheters ( e . g ., chlorhexidine bathing , scrubbing the hub , site examinations ) as well as alterations to processes of care ( such as risking disrupting catheter dressings when placing patients in a prone position ) all have the potential to contribute to an increase in CLABSIs .”
References :
Centers for Disease Control and Prevention ( CDC ). 2019 National and State HAI Progress Report .
Fakih MG , Bufalino A , et al . Coronavirus disease 2019 ( COVID-19 ) pandemic , central-line-associated bloodstream infection ( CLABSI ), and catheter-associated urinary tract infection ( CAUTI ): The urgent need to refocus on hardwiring prevention efforts . Infect Control Hosp Epidemiol . 2021 Feb 19 ; 1-6 . doi : 10.1017 / ice . 2021.70
McMullen KM , Smith BA and Rebmann T . Impact of SARS-CoV-2 on hospital-acquired infection rates in the United States : Predictions and early results . Am J Infect Control . Am J Infect Control . 2020 Nov ; 48 ( 11 ): 1409-1411 . Published online 2020 Jul 2 . doi : 10.1016 / j . ajic . 2020.06.209
National Healthcare Safety Network ( NHSN ). Patient Safety Component Manual . Chapter 4 : Bloodstream Infection Event ( Central Line-Associated Bloodstream Infection and Non-central Line Associated Bloodstream Infection ). January 2021 .
Patel PR , Weiner-Lastinger LM , Dudeck MA , Fike LV , Kuhar DT , Edwards JR , Pollock D and Benin A . Impact of COVID-19 Pandemic on Central Line-Associated Bloodstream Infections During the Early Months of 2020 , National Healthcare Safety Network . Infect Control Hosp Epidemiol . March 2021 .
Sapiano MRP , Dudeck MA , et al . Impact of coronavirus disease 2019 ( COVID-19 ) on US Hospitals and Patients , April – July 2020 . Infect Control Hosp Epidemiol . Feb . 19 , 2021
With IntelObserve ® electronic hand hygiene monitoring system , your facility will far exceed the results of direct observation – clinically and economically . Let us show you how it works .
It ’ s accurate
Easy-to-use
Affordable
Request a free demonstration
Medline Industries , Inc . Three Lakes Drive , Northfield , IL 60093 | 1-800-MEDLINE ( 633-5463 ) © 2021 Medline Industries , Inc . All rights reserved . IntelObserve is a registered trademark of Intelligent Observation , Inc and Medline is a registered trademark of Medline Industries , Inc . MKT19W1498757 / 80
1
2 www . healthcarehygienemagazine . com • april 2021
31