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MethodsMEDLINE, EMBASE, CINHAL, and Web of Science were searched from inception to July 2016; conference proceedings were searched to identify additional studies. Study selection and data extraction were performed independently by 2 authors.ConclusionsAvailable evidence suggests that antimicrobial PICCs may reduce CLABSI, especially in high-risk subgroups. Randomized trials are needed to assess efficacy across patient populations.Review of Best Practices for CLABSI Prevention and the Impact of Recent Legislation on CLABSI ReportingReferences 3
CLABSI PREVENTIONBenjamin, W., & Reba, U. (2016). Review of Best Practices for CLABSI Prevention and the Impact of Recent Legislation on CLABSI Reporting. SAGE Open, Vol 6, Iss 4 (2016), (4), doi:10.1177/2158244016677747AbstractCentral line-associated bloodstream infections (CLABSI) are a very common source of healthcare-associated infection (HAI). Incidence of CLABSI has been significantly reduced through the efforts of nurses, healthcare providers, and infection preventionists. Extrinsic factors such as recently enacted legislation and mandatory reporting have not been closely examined in relation to changes in rates of HAI. The following review will examine evidence-based practices related to CLABSI and how they are reported, as well as how the Affordable Care Act, mandatory reporting, and pay-for-performance programs have affected these best practices related to CLABSI prevention. There is disconnect in the methods and guidelines for reporting CLABSI between these programs, specifically among local monitoring agencies and the various federal oversight organizations. Future research will focus on addressing the gap in what defines a CLABSI and whether or not these programs to incentivize hospital to reduce CLABSI rates areeffective.ConclusionAlthough research on CLABSIs has been widespread and fairly comprehensive, new federal legislation such as the ACA has created gaps in our knowledge about how the use of incentives and penalties affects reporting and incidence of HAIs such as CLABSIs. Studies have been conducted in various states on how effective these measures are at achieving their goals, but to truly capture its ramifications on a widespread scale, each hospital needs individual analysis. States and specific hospitals include a unique environment that may respond well or poorly to 4
CLABSI PREVENTIONgeneralized legislative measures and should be individually analyzed. Laws and legal guidelines are perhaps one of the most drastic instances of inciting this change to happen. Obviously, some regulations may be unhelpful or even harmful in furthering healthcare’s progress, but it is impossible to know for sure what the ramifications are without focused study and analysis. Although it seems unlikely that we will ever live in a world without these deadly infections, there is still obvious room for improvement, which can reasonably and economically be attained.