A task analysis of central line-associated bloodstream infection (CLABSI) surveillance in home infusion therapy

Susan M Hannum; Opeyemi Oladapo-Shittu; Alejandra B Salinas; Kimberly Weems; Jill Marsteller; Ayse P Gurses; Sara E Cosgrove; Sara C Keller

doi:10.1016/j.ajic.2022.01.008

A task analysis of central line-associated bloodstream infection (CLABSI) surveillance in home infusion therapy

Am J Infect Control. 2022 May;50(5):555-562. doi: 10.1016/j.ajic.2022.01.008. Epub 2022 Mar 24.

Authors

Susan M Hannum¹, Opeyemi Oladapo-Shittu², Alejandra B Salinas², Kimberly Weems³, Jill Marsteller⁴, Ayse P Gurses⁵, Sara E Cosgrove⁶, Sara C Keller⁷

Affiliations

¹ Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
² Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD.
³ Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD.
⁴ Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD.
⁵ Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD.
⁶ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Hospital Epidemiology and Infection Control, Johns Hopkins Hospital, Baltimore, MD; Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD.
⁷ Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Health Policy & Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Armstrong Institute of Patient Safety and Quality, Johns Hopkins University School of Medicine, Baltimore, MD. Electronic address: skeller9@jhmi.edu.

Abstract

Background: Barriers for home infusion therapy central line associated bloodstream infection (CLABSI) surveillance have not been elucidated and are needed to identify how to support home infusion CLABSI surveillance. We aimed to (1) perform a goal-directed task analysis of home infusion CLABSI surveillance, and (2) describe barriers to, facilitators for, and suggested strategies for successful home infusion CLABSI surveillance.

Methods: We conducted semi-structured interviews with team members involved in CLABSI surveillance at 5 large home infusion agencies to explore work systems used by members of the agency for home infusion CLABSI surveillance. We analyzed the transcribed interviews qualitatively for themes.

Results: Twenty-one interviews revealed 8 steps for performing CLABSI surveillance in home infusion therapy. Major barriers identified included the need for training of the surveillance staff, lack of a standardized definition, inadequate information technology support, struggles communicating with hospitals, inadequate time, and insufficient clinician engagement and leadership support.

Discussion: Staff performing home infusion CLABSI surveillance need health system resources, particularly leadership and front-line engagement, access to data, information technology support, training, dedicated time, and reports to perform tasks.

Conclusions: Building home infusion CLABSI surveillance programs will require support from home infusion leadership.

Keywords: Central venous catheter; Health care associated infection; ambulatory care; human factors engineering; infection preventionist.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Catheter-Related Infections* / epidemiology
Catheter-Related Infections* / prevention & control
Catheterization, Central Venous*
Cross Infection*
Home Infusion Therapy*
Humans
Leadership
Sepsis*

Grants and funding

R01 HS027819/HS/AHRQ HHS/United States