I have been collecting data on all PICCs we place in my organization since 1993. This included all complications from insertion to removal of the line, including complications that occurred post discharge, and including outpatient catheter days. We have now switched to counting ONLY inpatient catheter days, and only complications that occur while inpatients.
My question is: Patient gets a PICC placed here on Sept. 1. Goes home with the PICC on Sept. 7. Catheter days = 6. Patient is readmitted on Sept. 20 with same PICC, no complications. Patient is inhouse 2 weeks and develops a blood stream infection on Day 10 of this readmission.
Do we count the catheter days from the readmission? Do we count the CLABSI? Is there a timeframe when we would NOT count the infection? I know we would not count it if the patient was admitted with the CLABSI. What about 1-2-3-4 days later? If we count the CLABSI, we must count the line days, right?
Sorry if I am overthinking this but can't seem to find an answer. Thanks in advance!
Look at the CLABSI definition on CDC website. I am pretty sure they state 48 hours after insertion with s&s of BSI. If there is no evidence of a BSI at the readmission, and this develops while the patient is in the facility, then it is considered to be a hospital acquired infection. CMS will not reimburse for the treatment and I would think you have to count it as CLABSI. Lynn
Lynn Hadaway, M.Ed., RN, BC, CRNI
Lynn Hadaway Associates, Inc.
126 Main Street, PO Box 10
Milner, GA 30257
Website http://www.hadawayassociates.com
Office Phone 770-358-7861
Thanks - helpful.
Wendy Erickson RN
Eau Claire WI
At this point in time, per CDC, there is no minimum period of time that the central line must be in place in order for the BSI to be considered central line associated. If you are only tracking inpatient complications/infections you would only count the days the patient is admitted. So for the scenario you proposed, central line days for this patient in Sept. would be 21 days, (7 days on first admission + 14 days on second admission). This number may be plus or minus one day depending on the time of day you collect your line day count and how the line insertion and readmission fall within that time frame. Yes you would count this CLABSI. New criteria may come out next year stating that the patient must be admitted for 48 hours before an infection is considered nosocomial.
Yolanda Ballam
Infection Prevention and Control
Yolanda Ballam