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CLABSI

Central Line Associated Blood Stream Infection (CLABSI) Prevention

In 2010, ANZICS and the Australian Commission on Safety and Quality in Health Care (ACSQHC) led a project to decrease Australian ICU CLABSI to <1/1000 line days and to facilitate accurate and consistent CLABSI measurement, with timely reporting to clinicians and benchmarking opportunities.  The project was based on successful Australian and international projects which focussed on strict aseptic technique and maximal barrier precautions at the time of central line insertion. Resources for clinicians were developed including an insertion checklist, insertion compliance calculator and comprehensive guidelines for ongoing care.

For further information regarding CLABSI Prevention please contact the ANZICS Safety and Quality Executive Officer.

ANZICS CORE CLABSI Registry

The ANZICS CORE CLABSI Registry and reporting system enables ICUs to compare CLABSI rates against peer units throughout Australia.

For more information on the ANZICS CORE CLABSI Registry please click here.

Resources

ANZICS Central Line Insertion & Maintenance Guideline

The ANZICS Central Line Insertion and Maintenance Guideline provides guidance on all aspects of preventing infection during central line insertion and maintenance.

ANZICS Central Line Insertion Checklist (pdf)

ANZICS Central Line Insertion Checklist (word version)

The Insertion Checklist is designed for use at the bedside during central line insertion.  When possible it should be completed by someone who observes the whole procedure, but is not a proceduralist. The observer and assistant will most likely be the same person.

The information on the checklist can be used to calculate compliance with the guidelines, using the compliance calculator. The items in the grey boxes are the essential elements to be considered, however individual ICUs may want to collect the other data as well.

We recommend this data is collected at least three times per year, on all central line insertions for a month, and whenever there is an n increase in the CLAB​SI rate above 1/1000 line days. Some ICUS may wish to collect the data at all times to provide ongoing feedback to staff, especially where there are few lines inserted.

ANZICS Central Line Insertion Compliance Calculator

The Insertion Compliance Calculator spreadsheet will automatically calculate your compliance with each essential element of the checklist, and overall compliance with all elements.

Enter data for each patient on a separate line. Additional lines can be added and the formulae will not be affected.

ANZICS CLABSI Prevention Poster

ANZICS CLABSI Prevention made easy Postcard

CLABSI Surveillance​

In order to ensure consistency in surveillance the ACSQHC publish the national definition of Central Line Associated Blood Stream Infection Case​ on their website. Click here to access the ACSQHC Surveillance definition.

There are two components to CLABSI surveillance – the number of infections (numerator) and the number of line days (denominator).

Infections

We suggest the infections (numerator) be collected in collaboration with Infection Prevention and Control Departments, as they are usually well versed in the surveillance process and may have systems already in place to collect positive blood cultures.

Line Days

ANZICS weekly central line-day count

There are several ways in which line days can be counted:

  1. By counting the number of days each patient has a central line insitu; this can be labour intensive unless there is a computerised information system in use that can be queried for each specific month.
  2. By counting the number of patients with a central line every day.
  3. If unable to do a count every day
    • By counting the number of patients with a central line on as many days as possible and add together
    • Divide the total number of lines by the number of days on which the count was done
    • Multiply by the number of days in that month.

If using system 3, the count should be done at least Monday, Wednesday and Friday. If any of these days area a public holiday, a count should be done on the day before or after. Ideally, the count should be done at the same time each day.

The weekly Line-day Count Tool is designed for use by the person who physically performs the count; it can be adapted to suit different sized units, and can be used without any technical or nursing knowledge.

CLABSI Rate

ANZICS CLABSI rate calculator

If you would like to calculate your CLABSI rate:

  • Enter the daily line count in each month: only enter 0 if there were no lines in situ that day; if you didn’t count that day leave blank
  • Enter the number of infections into the numerator sheet and the CLABSI rate will automatically be calculated.