Abstract:
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.
Reference:Saito H, Nourollahi S, Alsharif MN, Bahadori B, Tjoa T, Mauricio A, Bethlahmy J, Chang J, Rashid S, Nelson EL, Van Etten RA, Armendariz L, Torres V, Masson S, Esteves M, Saavedra R, Singh RD, Gohil SK. Improving central line-associated bloodstream infection prevention practices in oncology clinic patients: mobile-app based surveillance & response. Infect Control Hosp Epidemiol. 2025 Apr 10:1-7. doi: 10.1017/ice.2025.16. Epub ahead of print. PMID: 40207457.