This report by the California Department of Public Health (CDPH) on central line-associated bloodstream infections (CLABSI) is the first to use data submitted by California hospitals to CDPH through the Centers for Disease Control and Prevention (CDC) web-based surveillance and reporting system called the National Healthcare Safety Network (NHSN). Using data reported from April 1, 2010 through March 31, 2011, this report provides perspective on the prevention and control of CLABSI in California. It is the first CDPH report to provide California average rates which are peer-based standards against which hospitals are compared. It is also the first CDPH report to present CLABSI rates by patient care locations where patients with similar medical conditions receive comparable levels of care. Hospital-specific CLABSI rates presented by patient care locations and statistically compared with peer-based standards provide a comprehensive but straightforward way to assess CLABSI rates within and between hospitals.
CLABSI rates are affected by many factors, including clinical and infection control practices related to central line insertion and maintenance practices, patient-based risk factors, and the surveillance methods used by reporting hospitals. To ensure appropriate interpretation of these data, readers are encouraged to consider the context of these CLABSI rates. A low CLABSI rate may reflect strong infection prevention policies or may reflect surveillance methods that result in under-detection of infections, including failure to use accepted surveillance definitions and protocols. Similarly, a high rate may reflect lapses in infection prevention practices or more aggressive surveillance and identification of CLABSIs. Bearing in mind their limitations, hospitals and healthcare providers can use these rates to examine their patient safety practices and improve quality of care, as appropriate. The public can use these rates as a starting point to discuss patient safety and quality of care with their healthcare providers.
For quick reference to California average CLABSI rates for each patient care location, see California Average CLABSI Rates
What is in this table? This table lists the statewide average CLABSI rates and average device (central line) utilization ratios for each patient care location. The distributions of hospital-specific CLABSI rates are presented by key percentiles for patient care locations with at least 10 reporting hospitals. California average CLABSI rates are the peer-based standards against which individual hospital CLABSI rates are compared. Device (central line) utilization ratios are a measure of how often central lines are used in each location. Important explanatory information, including definitions, is available in the full report (see below).
For quick reference to a summary table of statistical comparisons of hospital CLABSI rates with California average rates for each patient care location, see CLABSI Rate Comparisons: Hospitals to State Averages
What is in this table? Similar to consumer product evaluations, this table provides a visual summary of all hospitals listed in one "snap-shot" table. It lists California hospitals (alphabetically), patient care locations, and symbols identifying those hospital-specific locations where CLABSI rates were statistically higher, lower, or no different than state average rates. Important explanatory information, including definitions, is available in the full report (see below).
Detailed, hospital-specific CLABSI information for each of the patient care locations can be accessed by clicking on either of the CLABSI rate tables above and then clicking on the link for each patient care location. Detailed information for each patient care location includes an alphabetical list of California hospitals, numbers of CLABSI, central line days, and patient days, CLABSI rates and their 95% confidence intervals, device (central line) utilization ratios, and symbols indicating patient care locations that were statistically higher, lower, or no different from statewide average CLABSI rates.
For quick reference to CLABSI report narrative, see CLABSI Report Narrative
What is in the report narrative? The report narrative includes an executive summary, background information, methods and definitions, key findings, important considerations for interpretating CLABSI rates and suggested action steps for using CLABSI rate information. The full report contains the narrative and all the tables (see below).