CLABSI Toolkit - Chapter 2
Background on CLABSIs
Background on CLABSIs: Clinical Practice Guidelines, Position Papers, Initiatives on CLABSI Prevention, and Barriers to Best Practices
Chapter 2 provides background information on central line-associated bloodstream infections (CLABSIs) and an overview of the various guidelines, position papers, and initiatives on their prevention. Barriers to the implementation of best practices at the staff, unit, and organizational levels are also addressed.
Key points include the following:
- Clinical practice guidelines (CPGs) are statements of recommended practices intended to optimize patient care, based on a systematic review of the evidence by experts. Several countries, regions, and organizations have established CPGs pertaining to the prevention of CLABSIs, authored by governmental, professional, and public health organizations.
- Position papers, typically developed by professional organizations or societies, present evidence to support their own opinion, stance, or recommendation on a given issue — such as a particular central venous catheter (CVC) practice used in CLABSI prevention — with the goal of convincing the audience that the opinion promoted is valid and worth considering.
Recent international, national, regional, state, and single organizational campaigns and initiatives that have highlighted the preventability of CLABSIs by adhering to evidence-based preventive practices include those of the International Nosocomial Infection Control Consortium (INICC), the US Department of Health and Human Services (HHS), the Institute for Healthcare Improvement (IHI), the Canadian Patient Safety Institute (CPSI), the World Health Organization (WHO), and several other organizations.
- Common barriers to implementation of best practices to reduce or eliminate CLABSIs include lack of leadership support, lack of a safety culture, unavailability of resources, and issues with staffing, such as suboptimal nurse-to-patient ratios and inadequate education, training, and competence of health care personnel.
Clinical Practice Guidelines
Examples of International Clinical Practice Guidelines That Include CLABSI Prevention Strategies (corresponding to Table 2-1 of CLABSI Monograph Preventing Central Line–Associated Bloodstream Infections: A Global Challenge, A Global Perspective, pages 13–15)
Examples of Clinical Practice Guidelines or Practice Standards Developed by Organizations or Professional Societies Regarding Aspects of CLABSI Prevention or Diagnosis (corresponding to Table 2-2 of CLABSI Monograph, pages 15–21)
- Position Papers Related to CVCs, CLABSIs, and Their Prevention (corresponding to Table 2-3 of CLABSI Monograph, pages 21–22)
Initiatives and Campaigns
CLABSI Reduction Initiatives and Campaigns (adapted from Table 2-5 of CLABSI Monograph, pages 27–30)
Society for Healthcare Epidemiology of America/Infectious Diseases Society of America Compendium of Strategies to Prevent Healthcare-Associated Infection
- Central Line-Associated Bloodstream Infections Toolkit and Monograph