(1296) A Novel Reporting Tool Streamlines CLABSI Review

Introduction: Central line-associated bloodstream infections (CLABSIs) are a preventable source of patient morbidity and mortality. At our institution, 142 potential CLABSIs were reviewed in 2022. The CLABSI review process is burdensome on clinician time. We hypothesized using a novel reporting tool with data visualization facilitates faster review of Central Venous Access Device (CVAD) care and gives similar conclusions.

Methods: We identified 6 recent potential CLABSIs. Two researchers reviewed the cases for gaps and concerning findings in CVAD maintenance care documentation. The number of data points and time required to review the data were recorded. We developed a tool that retrieves CVAD maintenance documentation to identify care gaps, concerning findings and nurses’ free text comments. In a timeline view, the tool displays complete maintenance care as green dots, care gaps as yellow dots, and concerning findings as red dots to detect trends. Using the new tool, we reviewed the same 6 potential CLABSI cases for care gaps and concerning findings; the time for review was recorded.

Results: The median catheter days were 12.5 days (IQR 6-35) with a median of 3,012 flowsheet data points per patient (IQR 1,386-8,904). The median time for manual review was 16 minutes (IQR 9-31). The median time with the new tool was 6 minutes (IQR 4-8). Using a hierarchical Bayesian model, the reporting tool saved 0.7 minutes per catheter day (95% CrI 0.43-0.97), corresponding to an average effect of 13.9 minutes per case review. The tool had a probability of benefit that approached 100% certainty. Based on the number of cases at our institution in 2022, this tool would save an estimated 32.8 hours per year. The differences between reviewers in their conclusions on CVAD maintenance care were negligible.

Conclusions: CLABSI review requires evaluating thousands of data points, consuming clinician time and energy. Reporting tools with data visualization can significantly decrease the labor required to review potential CLABSIs and effectively identify opportunities for improvement.