The following two questions/situations relate to an ICU patient undergoing dialysis: 6/8/2005

  1. A patient with a dialysis catheter is in one of the ICUs under surveillance for CLABs. If this patient's dialysis catheter is only accessed in the dialysis center, are the central line-days for this patient counted in the ICU's central line-day count?
    No, in this instance, the central line-days would not be counted in the ICU central line-day count.
  2. A patient with a dialysis catheter is in one of the ICUs under surveillance for CLABs. Someone from the dialysis center comes to the ICU to perform the dialysis. Will the central line-days for this patient be counted in the ICU's central line-day count?
    Yes, in this instance, the central line-days would be counted in the ICU central line-day count.

Note: As it is with all surveillance protocols, you set a definition and apply it consistently. If the line is accessed (by any of the staff) on the unit where surveillance is being conducted, then the line is counted. We do, of course, realize that patients are occasionally dialized on the unit, but this is the exception rather than the rule -- the line days should be counted. 

HAI - CLAB Manual

  1. If a patient in an ICU has a temporary (Quinton) or tunneled (ASHE) hemodialysis catheter, is that device counted as a central line in the central line-days? 5/20/2005
  2. Do central lines include the following: implantable-ports, non-tunneled TLC, Swan Ganz catheter, tunneled-Broviac, Groshong, Quinton, Hickman, ASHE catheter, PICC, and umbilical lines? If yes, would they be counted in central line-days for that unit? 5/20/2005
  3. Are permanent shunts and balloon pumps considered central lines? 5/20/2005
  4. If a patient is admitted to the ICU with a central line in place, is it counted in the central line-days? 5/20/2005
  5. What if: a patient had a central line inserted in the ICU; 6 days later the patient has a positive blood culture; and the patient meets the definition for laboratory confirmed bloodstream infection (LCBI). Would this patient be counted as a CLAB infection? 5/20/2005
  6. How do you determine which unit to “credit” with a bloodstream infection (BSI)? E.g., on May 2 patient is in the medical ICU; on May 3 patient is transferred to the coronary ICU; symptoms develop on May 4. Which unit is “credited”? 5/20/2005
  7. What should be done if a device-day is not counted? 5/20/2005
  8. Will maternally-acquired infections in the NICU be counted as CLAB infections? 5/20/2005
  9. What should be done if the device-day count sheet is lost or if the person who is designated to count does not complete it for a month? 5/20/2005
  10. The following two questions/situations relate to an ICU patient undergoing dialysis: 6/8/2005
  11. Can a patient have more than one CLAB infection during his/her stay in the ICU? 7/1/2005
  12. Does the birthweight of the infant ever change? E.g., an infant is admitted to a NICU from another hospital. Do you use the weight on admission or do you use the birthweight? 9/16/2005
  13. If the patient is discharged with a central line in place and returns two to four weeks after discharge with a central line infection, should this infection be counted as a healthcare-associated infection? 9/28/2005

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