Catheter-related bloodstream infections (CR-BSIs) are defined as bacteremia/fungemia in a patient with an intravascular catheter with at least one positive blood culture obtained from a peripheral vein, clinical manifestations of infection (i.e., fever, chills, and/or hypotension), and no apparent source for the bloodstream infection except the catheter.  Bloodstream infections are considered to be associated with a central line if the line was in use during the 48-hour period before the development of the bloodstream infection.  If the time interval between the onset of infection and device use is greater than 48 hours, there should be compelling evidence that the infection is related to the central line. [1]

For a particular time period, we are interested in the total number of cases of CR-BSIs.  For example, if in February there were 12 cases of CR-BSIs, the number of cases would be 12 for that month.  We want to be able to understand that number as a proportion of the total number of days that patients had central lines.  Thus, if 25 patients had central lines during the month and, for purposes of example, each kept their line for 3 days, the number of catheter days would be 25 x 3 = 75 for February.  The CR-BSI Rate per 1,000 catheter days then would be 12/75 x 1000 = 160.

References:

[1]  Appendix A, CDC Guideline MMWR. Aug. 9 2002;51(RR10):27-28.

Decrease the central line catheter-related bloodstream infection (CR-BSI) rate per 1,000 central line-days by 50 percent within 12 months.

Report the monthly catheter-related bloodstream infection rates for the last several months. This will serve as your baseline. Continue to track the measure monthly.  If possible, track the rate in an annotated run chart, with notes reflecting any interventions you made to improve. 

If your organization’s infection control practitioner reports data quarterly for other review or accreditation agencies, this data should be disaggregated and reported monthly.