Hiroki Saito, Shereen Nourollahi, Mohamad N Alsharif, Bardia Bahadori, Tom Tjoa, Amarah Mauricio, Jessica Bethlahmy, Justin Chang, Syma Rashid, Edward L Nelson, Richard A Van Etten, Linda Armendariz, Victor Torres, Sandra Masson, Marlene Esteves, Raheeb Saavedra, Raveena D Singh, Shruti K Gohil
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Cox proportional hazards models compared days-to-removal of lines with localized inflammation/infection. Chi-square test compared bacteremia rates before and after intervention.</p><p><strong>Setting: </strong>Oncology clinic at a large medical center.</p><p><strong>Patients: </strong>Oncology clinic adult patients with PICCs.</p><p><strong>Intervention: </strong>CLABSI prevention program consisting of an actionable scoring system for identifying insertion site infection/inflammation coupled with a mobile-app enabling photo-assessments and automated physician alerting for remote response.</p><p><strong>Results: </strong>We completed 5,343 assessments of 569 PICCs in 401 patients (baseline: 2,924 assessments, 300 PICCs, 216 patients; intervention: 2,419 assessments, 269 PICCs, 185 patients). The intervention was associated with a 92% lower likelihood of having a dressing with peeling (OR 0.08, 95%CI 0.04-0.17, <i>P</i> < 0.001), 53% lower local inflammation/infection (OR 0.47, 95%CI 0.27-0.84, <i>P</i> < 0.011), and 24% (non-significant) lower CLABSI rates (<i>P</i> = .63). Physician mobile-app alerting and response enabled 80% lower risk of lines remaining in place after inflammation/infection was identified (HR 0.20, 95%CI:0.14-0.30, <i>P</i> < 0.001) and 85% faster removal of infected lines from mean (SD) 11.1 (9.7) to 1.7 (2.4) days.</p><p><strong>Conclusions: </strong>A mobile-app-based CLABSI prevention program decreased frequency of inflamed/infected central line insertion sites and increased speed of removal when inflammation/infection was found.</p>","PeriodicalId":13663,"journal":{"name":"Infection Control and Hospital Epidemiology","volume":" ","pages":"1-7"},"PeriodicalIF":3.0000,"publicationDate":"2025-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12034452/pdf/","citationCount":"0","resultStr":"{\"title\":\"Improving central line-associated bloodstream infection prevention practices in oncology clinic patients: mobile-app based surveillance & response.\",\"authors\":\"Hiroki Saito, Shereen Nourollahi, Mohamad N Alsharif, Bardia Bahadori, Tom Tjoa, Amarah Mauricio, Jessica Bethlahmy, Justin Chang, Syma Rashid, Edward L Nelson, Richard A Van Etten, Linda Armendariz, Victor Torres, Sandra Masson, Marlene Esteves, Raheeb Saavedra, Raveena D Singh, Shruti K Gohil\",\"doi\":\"10.1017/ice.2025.16\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objectives: </strong>To evaluate the impact of a mobile-app-based central line-associated bloodstream infection (CLABSI) prevention program in oncology clinic patients with peripherally inserted central catheters (PICCs).</p><p><strong>Design: </strong>Pre-post prospective cohort study with baseline (July 2015-December 2016), phase-in (January 2017-April 2017), and intervention (May 2017-November 2018). 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引用次数: 0
摘要
目的：评估基于移动应用程序的中心线相关血流感染（CLABSI）预防项目对肿瘤临床外周插入中心导管（picc）患者的影响。设计：前后前瞻性队列研究，包括基线研究（2015年7月- 2016年12月）、分期研究（2017年1月- 2017年4月）和干预研究（2017年5月- 2018年11月）。广义线性混合模型比较了干预与基线频率的局部炎症/感染和敷料脱皮。Cox比例风险模型比较了局部炎症/感染系的切除天数。卡方检验比较干预前后菌血症率。环境：大型医疗中心的肿瘤诊所。患者：肿瘤临床PICCs成年患者。干预措施：CLABSI预防计划包括一个可操作的评分系统，用于识别插入部位感染/炎症，再加上一个移动应用程序，可以进行照片评估和远程响应的自动医生警报。结果：我们在401例患者中完成了569例picc的5343次评估(基线：2924次评估，300例picc， 216例患者；干预：2419次评估，269次picc， 185例患者)。干预与敷料脱皮的可能性降低92% (OR 0.08, 95%CI 0.04-0.17, P < 0.001)，局部炎症/感染降低53% (OR 0.47, 95%CI 0.27-0.84, P < 0.011)， CLABSI发生率降低24%（无统计学意义）相关（P = 0.63）。医生的移动应用程序警报和响应使得在发现炎症/感染后，细胞株留在原位的风险降低了80% (HR 0.20, 95%CI:0.14-0.30, P < 0.001)，并且从平均（SD） 11.1（9.7）到1.7（2.4）天内，将感染细胞株移除的速度提高了85%。结论：基于移动应用程序的CLABSI预防程序减少了中心线插入部位发炎/感染的频率，并在发现炎症/感染时加快了移除速度。
Improving central line-associated bloodstream infection prevention practices in oncology clinic patients: mobile-app based surveillance & response.
Objectives: To evaluate the impact of a mobile-app-based central line-associated bloodstream infection (CLABSI) prevention program in oncology clinic patients with peripherally inserted central catheters (PICCs).
Design: Pre-post prospective cohort study with baseline (July 2015-December 2016), phase-in (January 2017-April 2017), and intervention (May 2017-November 2018). Generalized linear mixed models compared intervention with baseline frequency of localized inflammation/infection and dressing peeling. Cox proportional hazards models compared days-to-removal of lines with localized inflammation/infection. Chi-square test compared bacteremia rates before and after intervention.
Setting: Oncology clinic at a large medical center.
Patients: Oncology clinic adult patients with PICCs.
Intervention: CLABSI prevention program consisting of an actionable scoring system for identifying insertion site infection/inflammation coupled with a mobile-app enabling photo-assessments and automated physician alerting for remote response.
Results: We completed 5,343 assessments of 569 PICCs in 401 patients (baseline: 2,924 assessments, 300 PICCs, 216 patients; intervention: 2,419 assessments, 269 PICCs, 185 patients). The intervention was associated with a 92% lower likelihood of having a dressing with peeling (OR 0.08, 95%CI 0.04-0.17, P < 0.001), 53% lower local inflammation/infection (OR 0.47, 95%CI 0.27-0.84, P < 0.011), and 24% (non-significant) lower CLABSI rates (P = .63). Physician mobile-app alerting and response enabled 80% lower risk of lines remaining in place after inflammation/infection was identified (HR 0.20, 95%CI:0.14-0.30, P < 0.001) and 85% faster removal of infected lines from mean (SD) 11.1 (9.7) to 1.7 (2.4) days.
Conclusions: A mobile-app-based CLABSI prevention program decreased frequency of inflamed/infected central line insertion sites and increased speed of removal when inflammation/infection was found.
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