April 7, 2011

Message from Deputy Vice Chancellor Pinson about Central Line-Associated Bloodstream Infections

Dear Colleagues,

Yesterday, an article ran in The Tennessean about the Tennessee Department of Health’s 2009 report on central line-associated blood stream infections (CLABSI). The story, titled Bloodstream Infections Trouble Two Hospitals, cites self-reported hospital infection data from Vanderbilt and other Tennessee hospitals.

The Tennessean’s article, while accurate historically, may create the impression we were only recently aware of CLABSI rates at VUMC and are “turning the corner” by addressing the matter now. I would like to take this opportunity to clarify a few facts about our efforts to address the issue of these infections.

The state report cited by The Tennessean addresses CLABSI data for the period of January through December 2009, but does not include more recent data. The prevention of all health care-associated infections has long been an institutional priority for Vanderbilt, as reflected by our initial pioneering efforts with the use of the “central line bundle” in 2003 to prevent CLABSIs in the ICU, an effort for which we received a citation from the Centers for Disease Control and Prevention in 2005. Further, when the data about the CLABSI rates rising again became apparent, we had an “all hands on deck” approach to solving this issue.

While we have always worked diligently to produce superior outcomes for all patients, we have been working aggressively across every inpatient and outpatient area for the past two years regarding all aspects of infection prevention. Since the period included in this report, our overall infection rates have fallen dramatically across all areas and are now well below national benchmarks. The rates for CLABSI are today nicely below average, along with rates of urinary catheter infections, ventilator acquired infections, and surgical site infections.

As evidence of the impact of our efforts, I would like to report that from July 2010 through February 2011, CLABSI rates among Vanderbilt’s eight intensive care units were 30 percent below the national average. In December 2010 and again in February 2011, no hospitalized patient at the Monroe Carell Jr. Children’s Hospital at Vanderbilt developed a CLABSI, a remarkable achievement. Further, our current level of hand washing compliance, the most important preventive practice to reduce health care-associated infections overall, is nearly 90 percent and rising.

Much work has gone into bringing down and keeping these infection rates low and I want to thank and congratulate many for this great work. And I certainly do not want the faculty and staff to feel this work has been diminished by or be discouraged by the newspaper report.

For an accurate and up-to-date summary of our efforts to reduce central-line associated infections, I would ask that you please review the following article published in the March 3 issue of the VUMC Reporter: http://wwwnew.mc.vanderbilt.edu/reporter/index.html?ID=10311

C. Wright Pinson, MBA, M.D.
Deputy Vice Chancellor for Health Affairs
CEO of the Vanderbilt Health System