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"A mobile-app-based CLABSI prevention program decreased the frequency of inflamed/infected central line insertion sites, improved dressing integrity, increased speed of removal when inflammation/infection were found, and reduced infection-related hospitalization risk" Singh et al (2025).
App-based CLABSI prevention program

Abstract:

Objectives: To evaluate the impact of a mobile-app-based central line-associated bloodstream infection (CLABSI) prevention program in nursing home residents with peripherally inserted central catheters (PICCs).

Design: Pre-post prospective cohort study with baseline (September 2015-December 2016), phase-in (January 2017-April 2017), and intervention (May 2017-December 2018). Generalized linear mixed models compared intervention with baseline frequency of localized inflammation/infection, dressing peeling, and infection-related hospitalizations. Cox proportional hazards models compared days-to-removal of lines with localized inflammation/infection.

Setting: Six nursing homes in Orange County, California.

Patients: Adult nursing home residents 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 8,131 assessments of 817 PICCs in 719 residents (baseline: 4,865 assessments, 422 PICCs, 385 residents; intervention: 4,264 assessments, 395 PICCs, 334 residents). The intervention was associated with 57% lower odds of peeling dressings (OR 0.43, 95% CI 0.28-0.64, P < .001), 73% lower local inflammation/infection (OR = 0.27, 95% CI: 0.13-0.56, P < .001), and 41% lower risk of infection-related hospitalizations (OR = 0.59, 95% CI: 0.42-0.83, P = .002). Physician mobile-app alerting and response enabled 62% lower risk of lines remaining in place after inflammation/infection was identified (HR 0.38, CI: 0.24-0.62, P < .001) and 95% faster removal of infected lines from mean (SD) 19 (20) to 1 (2) days.

Conclusions: A mobile-app-based CLABSI prevention program decreased the frequency of inflamed/infected central line insertion sites, improved dressing integrity, increased speed of removal when inflammation/infection were found, and reduced infection-related hospitalization risk.

Reference:

Singh RD, Bahadori B, Tjoa T, Alsharif MN, Nourollahi S, Chang J, Mauricio A, Bethlahmy J, Rashid S, Saavedra R, Ashbaugh IY, Tam S, Gohil SK. A telehealth approach to central line-associated bloodstream infection prevention activities in nursing homes: the SAFER lines program. Infect Control Hosp Epidemiol. 2025 Feb 3:1-7. doi: 10.1017/ice.2024.203. Epub ahead of print. PMID: 39895091.

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