Characterizing the relationship between coronavirus disease 2019 (COVID-19) and central-line-associated bloodstream infection (CLABSI) and assessing the impact of a nursing-focused CLABSI reduction intervention during the COVID-19 pandemic.

OBJECTIVE: To examine the impact of SARS-CoV-2 infection on CLABSI rate and characterize the patients who developed a CLABSI. We also examined the impact of a CLABSI-reduction quality-improvement project in patients with and without COVID-19. DESIGN: Retrospective cohort analysis. SETTING: Academic 889-bed tertiary-care teaching hospital in urban Los Angeles. PATIENTS OR PARTICIPANTS: Inpatients 18 years and older with CLABSI as defined by the National Healthcare Safety Network (NHSN). INTERVENTION(S): CLABSI rate and patient characteristics were analyzed for 2 cohorts during the pandemic era (March 2020-August 2021): COVID-19 CLABSI patients and non-COVID-19 CLABSI patients, based on diagnosis of COVID-19 during admission. Secondary analyses were non-COVID-19 CLABSI rate versus a historical control period (2019), ICU CLABSI rate in COVID-19 versus non-COVID-19 patients, and CLABSI rates before and after a quality- improvement initiative. RESULTS: The rate of COVID-19 CLABSI was significantly higher than non-COVID-19 CLABSI. We did not detect a difference between the non-COVID-19 CLABSI rate and the historical control. COVID-19 CLABSIs occurred predominantly in the ICU, and the ICU COVID-19 CLABSI rate was significantly higher than the ICU non-COVID-19 CLABSI rate. A hospital-wide quality-improvement initiative reduced the rate of non-COVID-19 CLABSI but not COVID-19 CLABSI. CONCLUSIONS: Patients hospitalized for COVID-19 have a significantly higher CLABSI rate, particularly in the ICU setting. Reasons for this increase are likely multifactorial, including both patient-specific and process-related issues. Focused quality-improvement efforts were effective in reducing CLABSI rates in non-COVID-19 patients but were less effective in COVID-19 patients.

Perception of interdisciplinary collaboration between ICU nurses and resident physicians during the COVID-19 pandemic.

Multidisciplinary collaboration is the hallmark of quality critical care. Prior studies have shown that nurses and physicians have different perceptions on communication and collaboration in the ICU. The Covid-19 pandemic has served to both strain and strengthen relationships between nurses and resident physicians in the ICU. This study used a survey-based approach sought to identify the similarities and differences between perception of collaboration between ICU nurses and resident physicians taking care of patients during the pandemic, and to identify whether they felt that the pandemic impacted the collaborative spirit of critical care. Although findings from this study suggest that overall residents and nurses perceive collaboration similarly, the COVID-19 pandemic may be differentially affecting the interdisciplinary dynamics of the ICU.

Multispecialty Nursing During COVID-19:: Lessons Learned in Southern California.

A multispecialty nursing team plays a crucial role in key decision making, education, prevention, screening, assessment, diagnosis, management, data collection and dissemination of best practices during the novel coronavirus disease (COVID-19) pandemic. Using examples from a large, tertiary medical center in Los Angeles, this paper highlights contributions made by multispecialty nursing specialties to optimize health and safety for patients and frontline health care workers. Recognizing nurses' ongoing critical role encourages and informs further collaboration and serves as a catalyst to innovation for a healthier tomorrow. The result of the COVID-19 pandemic will be felt for years to come.