Successful practices to reduce central line-associated bloodstream infections post pandemic: A qualitative study.

BACKGROUND: Central Line-Associated Bloodstream Infections (CLABSIs) decreased in U.S. hospitals over the last decade, but CLABSI rates increased during the COVID-19 pandemic disrupting the downward trend. This study explored factors contributing to the reduction of CLABSI, identifying deviations in infection prevention and control protocol during the pandemic, actions taken to address the increase in CLABSI, and factors promoting sustained progress. METHODS: This qualitative study used the National Healthcare Safety Network data. The Centers for Disease Control and Prevention identified hospitals with elevated CLABSI standardized infection ratios (SIR) >1 between Q1 2019 - Q4 2021 followed by four quarters of sustained reduction (CLABSI SIR <1). Joint Commission researchers conducted semi-structured phone interviews with infection preventionist professionals from six hospitals representing these performance patterns. RESULTS: Interview themes suggested that staffing shortages (83%) and less vigilant central line practices (100%) contributed to increased CLABSI SIR during the pandemic. Organizations described evidence-based interventions, such as using chlorhexidine gluconate for skin preparation, along with other innovative strategies they used to establish reduced CLABSI rates. CONCLUSIONS: Despite challenges faced during the COVID-19 pandemic, some health care organizations have excelled in their efforts to reduce and sustain low rates of CLABSI by implementing evidence-based practices, innovative solutions, and education.

Evaluating the Prevalence of Four Recommended Practices for Suicide Prevention Following Hospital Discharge.

BACKGROUND: The Joint Commission's National Patient Safety Goal (NPSG) for suicide prevention (NPSG.15.01.01) requires that accredited hospitals maintain policies/procedures for follow-up care at discharge for patients identified as at risk for suicide. The proportion of hospitals meeting these requirements through use of recommended discharge practices is unknown. METHODS: This cross-sectional observational study explored the prevalence of suicide prevention activities among Joint Commission-accredited hospitals. A questionnaire was sent to 1,148 accredited hospitals. The authors calculated the percentage of hospitals reporting implementation of four recommended discharge practices for suicide prevention. RESULTS: Of 1,148 hospitals, 346 (30.1%) responded. The majority (n = 212 [61.3%]) of hospitals had implemented formal safety planning, but few of those (n = 41 [19.3%]) included all key components of safety planning. Approximately a third of hospitals provided a warm handoff to outpatient care (n = 128 [37.0%)] or made follow-up contact with patients (n = 105 [30.3%]), and approximately a quarter (n = 97 [28.0%]) developed a plan for lethal means safety. Very few (n = 14 [4.0%]) hospitals met full criteria for implementing recommended suicide prevention activities at time of discharge. CONCLUSION: The study revealed a significant gap in implementation of recommended practices related to prevention of suicide postdischarge. Additional research is needed to identify factors contributing to this implementation gap.