Tuesday October 24, 2006
CR-BSIs

One of the parameter or measurement of ICU is the decreasing rate of CR-BSIs. (Central line catheter-related bloodstream infections). CR-BSIs are calculated or presented usually per 1000 central line-days. The formula for the CR-BSI Rate per 1000 catheter days is:

Total no. of CR-BSI cases / No. of catheter days x 1000 = CR-BSI rate per 1000 catheter days


For example:

In a given month, you had 100 central lines in your ICU and each stayed there for 4 days. Your total no. of catheter days are 100 X 4 = 400 days. Now you confirmed 15 cases of CR-BSIs. The CR-BSI Rate per 1000 catheter days in your ICU for that given month is 15 / 400 x 1000 = 37.5

On average per IHI report approximately 5.3 catheter-related bloodstream infections occur per 1,000 catheter days in ICUs.

Now your goal should be to decrease this number for your ICU.


Bonus Pearl: As against common belief, application of ointment at catheter insertion site does not decrease the infection rate. Actually application of antibiotic ointments (e.g., bacitracin) to catheter-insertion sites increases the rate of catheter colonization by fungi and promotes the emergence of antibiotic-resistant bacteria.


Related Site: Implement the Central Line Bundle (IHI)


Recommended Reading:

Preventing Complications of Central Venous Catheterization, David C. McGee, M.D.,, NEJM, March 03, Volume 348:1123-1133.