CLI - an overview | Patients and CLI | CLI reporting

Public Reporting of Central Line Bloodstream Infection

Central Line Bloodstream Infection (CLI-BSI) rates will be posted on the Ministry of Health and Long-Term Care Website and on the York Central Hospital Website as of April 30th, 2009. The quarterly report is available on the Ministry’s website: www.ontario.ca/patientsafety.  We will also post the quarterly CLI rates and case count data on the York Central Hospital website every three months.

What is a central line-associated blood stream infection (CLI-BSI)?
A central venous catheter (or “line”) is put into a patient’s vein usually when a patient requires long-term access to medication, fluids or nutrition intravenously (through an IV). A central line blood stream infection can occur when bacteria and/or fungi enters the blood stream, causing a patient to become sick. The bacteria most often comes from the patient’s skin but can come from a variety of places including wounds, and the environment.

What are the symptoms of CLIs?

• Redness, pain or swelling at or near the catheter site,
  
• Pain or tenderness along the path of the catheter,
  
• Drainage from the skin around the catheter, and
  
• Sudden fever or chills.

What are the risk factors for CLIs?
Anyone who has a central line can get an infection. The risk is higher if you:

• Are in the intensive care unit (ICU) (this is where the majority of patients have central lines),
  
• Have a serious underlying illness or debilitation,
  
• Are receiving bone marrow or chemotherapy, and
  
• Have the line in for an extended time.

How is CLI treated?
Treatment depends on the type of catheter, the severity of the infection and the patient’s overall health. Generally, your doctor will prescribe antibiotics to fight the infection and the central line may need to be removed. In some cases, the line is flushed with high doses of antibiotics to kill the germs causing the infection so that the line does not have to be removed.

Can you only get a central line infection in an ICU?
You can get a central line infection in any environment if you have a central line in place (i.e., a hospital ward or at home).  However, patients that develop a central line blood stream infection usually become sick very quickly, and are transferred to an ICU for immediate treatment.

The Ministry of Health and Long-Term Care has asked that CLI bloodstream infection rates in ICUs be publicly reported because this is where the majority of patients have central lines.

Do people contract central line infections because of improper sterilization of hospital equipment?
There are many different causes for central line infection. Infection control practices require that central lines are inserted into patients in a sterile environment, and with sterile equipment. Measures are put in place to reduce the chances of contracting a central line infection.

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What our Patients Should Know

CLI Fact Sheet for Patients and Visitors

Patient safety remains the most important priority for York Central Hospital and this involves ensuring that our patients are not at risk for contracting healthcare-associated infections such as central line bloodstream infection (CLI-BSI).

We have a number of practices in place to help prevent and control infections, including a comprehensive hand hygiene program. As of April 30, 2009, York Central Hospital, along with all Ontario hospitals, is required to post quarterly CLI-BSI rates to further promote accountability and transparency within the health system.

What are healthcare-associated infections?
Sometimes when patients are admitted to the hospital, they can get infections. These are called healthcare-associated infections.

What can patients do to help reduce their chances of infection?

• Patients should always follow instructions given to them by their healthcare team.
  
• Frequent hand cleaning is another way to prevent the spread of infection. Hand hygiene involves everyone in the hospital, including patients.