Continuous Quality Improvement

Concurrent Education Session - 60 minutes

2501 - The Central Line Insertion Site Assessment (CLISA) Score: The Case for Standardizing Language and Expectations for Action to Optimize Prevention Efforts.

Thursday, June 15
3:45 PM - 4:45 PM
Location: Oregon Convention Center, B 110-112

While national central line-associated bloodstream infection (CLABSI) prevention recommendations have focused on insertion practices, there has been relatively less attention on standardizing maintenance practices for assessment and removal of central lines. The advent of the peripherally inserted central catheter (PICC) line has increased central line use and dwell times both in and out-of-hospital settings, making maintenance a critically important aspect of CLABSI prevention. We recently developed the Central Line Insertion Site Assessment (CLISA) score to standardize visual assessments of central venous catheter sites and define expected actions. The CLISA score enables a uniform language and a programmable strategy that can be employed across care providers. By redefining and standardizing expectations of safe line care, the CLISA score highlights a proactive approach to combating the complacency that can sometimes plague compliance with daily infection prevention practices. It is now used throughout the University of California, Irvine, health system as standard of care and has increased alerting physicians and proactive removal of lines with localized infection. In this session, we review the impact of the CLISA score on localized infection and CLABSI rates in the inpatient setting and assess infection prevention needs in out-of-hospital settings, including outpatient clinics and skilled nursing facilities. We also examine how this approach optimized communication and standardized expectations across healthcare personnel disciplines and training levels toward a common understanding, bridging the gap between culture and practice.

Learning Objectives:


Shruti Gohil

Assistant Professor of Infectious Diseases; Associate Medical Director of Epidemiology and Infection Prevention
University of California, Irvine School of Medicine
University of California, Irvine
Orange, California

Dr. Gohil is an Assistant Professor of Infectious diseases and Associate Medical Director of Epidemiology and Infection Prevention at the University of California, Irvine. Her research interest centers on applied epidemiology and patient-oriented outcomes research to develop innovative ways to evaluate, detect, and intervene in the acquisition and spread of healthcare-associated infections across the continuum of care. Her current research focuses on initiatives to decrease central line associated bloodstream infections, including the creation and development of a novel assessment tool (CLISA: Central Line Insertion Site Assessment score) which standardizes the assessment of line insertion sites and links nursing assessments to physician actions. This effort has been successful in changing the culture and practice of device-associated infection prevention at UCI and is now being expanded to post-discharge settings including outpatient clinics and skilled nursing facilities. In addition to her work on device-associated infections, Dr. Gohil has led large, state-wide population studies examining potentially modifiable risk factors associated with infection-related readmissions and sepsis. Through this work, she has demonstrated the importance of post-discharge infection prevention efforts, particularly in long term care settings in preventing HAIs.

Presentation(s):

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Linda L. Dickey

Sr. Director, Quality, Pt. Safety & Infection Prevention
UC Irvine Healthcare
Orange, California

Recently recognized with APIC's 2017 President's Distinguished Service Award, Linda is an expert on healthcare facility design, who uses her infection preventionist background to improve guidelines and resources that help to ensure hospitals are designed in ways that reduce risks to patients and staff. She has been a member of APIC since 1994, and has served as an ambassador for APIC to other professional organizations that are essential partners for infection preventionists, including the American Society for Healthcare Engineering (ASHE), the American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE), and the Facility Guidelines Institute (FGI). In this capacity, she was influential in the development of a new standard from ASHRAE aimed at mitigating risks from legionella. She also has participated with the Center for Health Design in developing the Safety Risk Assessment process for the design of healthcare facilities.
She has been recognized for her expertise at the state and national level, and has developed numerous tools, checklists, and other resources to assist infection preventionists in navigating the complex areas of construction and renovation. Dickey has participated in numerous speaking engagements, as well as countless collaborative projects and publications.

Presentation(s):

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Kathleen McMullen

Manager - Infection Prevention and Occupational Health
Christian Hospital
Saint Louis, Missouri

Kathleen holds a Masters in Public Health concentrating in Epidemiology and Biostatistics from St. Louis University. She is currently the Manager of Infection Prevention and Occupational Health at Christian Hospital, a 300 bed community facility located in St. Louis, MO. Kathleen is Board Certified in Infection Prevention and Control and a Fellow of APIC.
Kathleen has been an active participant in APIC. She has served several times on her local APIC chapter board (Chapter 073, St. Louis MO). She currently serves on their Practice Guidance Committee as a liaison to AAMI. She has been a presenter at APIC. SHEA and ID Week national meetings and is the author of many IP-related papers and abstracts.

Presentation(s):

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2501 - The Central Line Insertion Site Assessment (CLISA) Score: The Case for Standardizing Language and Expectations for Action to Optimize Prevention Efforts.

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