Central line-associated bloodstream infections (CLABSIs) and catheter-associated urinary tract infections (CAUTIs) are quality metrics for many ICUs, and financial ramifications can be applied to hospitals and providers who perform poorly on these measures. Despite some perceived benefits to tracking these metrics, there are a range of issues associated with this practice: lack of a solid evidence base that documenting them has led to decreased infection rates, moral distress associated with identifying these infections, problems with their definitions, and others. We discuss each of these concerns while also including international perspectives then recommend practical steps to attempt to remediate use of the CLABSI and CAUTI metrics. Specifically, we suggest forming a task force consisting of key stakeholders (e.g., providers, Centers for Medicare & Medicaid Services (CMS), patients/families) to review CLABSI and CAUTI-related issues and then to create a summary statement containing recommendations to improve the use of these metrics.
Journal of critical care. 2023 Oct 03 [Epub]
Sarah E Nelson, Spyridoula Tsetsou, John Liang
Departments of Neurosurgery and Neurology, Mount Sinai West, 1000 10(th) Avenue, Suite 10B-65, New York, NY 10019, USA; Department of Neurology, Tufts Medical Center, 800 Washington Street, Boston, MA 02111, USA; Department of Neurology and Anesthesiology/Critical Care Medicine, Johns Hopkins University, 1800 Orleans Street, Baltimore, MD 21287, USA. Electronic address: ., Departments of Neurosurgery and Neurology, Mount Sinai West, 1000 10(th) Avenue, Suite 10B-65, New York, NY 10019, USA; Departments of Neurology and Neurosurgery, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA., Departments of Neurosurgery and Neurology, Mount Sinai West, 1000 10(th) Avenue, Suite 10B-65, New York, NY 10019, USA.