SSI/VAP/CLI

Central Line Infection (CLI) / Ventilator Associated Pneumonia (VAP) / Surgical Site Infection-Prevention Rates (SSI-Prevention)

What is a Central Line Infection (CLI) - Blood Stream Infection (CLI-BSI)?

When a patient requires medication through an IV for a long period of time, a central line (an IV that ends at or close to the heart or one of the main arteries) is often put in place. A central line infection can occur when bacteria and/or fungi enters the blood stream, causing a patient to become sick. The bacteria can come from a variety of places, though it may often come from the patient's skin.

The CLI rate is the number of ICU patients with new CLI (BSI) per 1,000 central line days, which is the total number of days per month that all the patients in the ICU had a central line in place)

CLI infection rate =

Total number of ICU related BSIs after 48 hours of central line placement

X 1000

Total number of central line days for ICU patients 18 years and older

What is a Ventilator Associated Pneumonia (VAP)?

VAP can develop in patients for many reasons. Because they are relying on an external machine to breath, their normal coughing, yawning, and deep breath reflexes are suppressed. Furthermore, they may have a depressed immune system, making them more vulnerable to infection. ICU teams have ways to try to assist patients with these normal breathing reflexes, but despite this, patients are still at risk for developing pneumonia.

The VAP rate and case count is reported using the following formula:

total # of ICU cases of VAP after 48 hours of mechanical ventilation	X 1,000
total # of ventilator days for ICU patients 18 years and older

MHA-SMGH Central Line Infection/
Ventilator Associated Pneumonia Quarterly Rates 2011

Quarter	Number of CLI Cases-	CLI Incident rate per 1000 line days	Number of VAP Cases	VAP Incident rate per 1000 ventilator days
Jan-March	0	0	0	0
Apr-Jun	0	0	0	0
July-Sept	0	0	0	0
Oct-Dec	0	0	0	0

Surgical Site Infection-Prevention (SSI-Prevention)

All Ontario hospitals that perform hip and/or knee joint replacement surgery must publicly report their data on the SSI-Prevention indicator which is the compliance rate for giving prophylactic antibiotics within one hour of making the surgical incision.

What is a Surgical Site Infection?

A surgical site infection (SSI) occurs at the site of a surgical incision. Germs can get into the incision area, and cause an infection. It can develop within 30 days of an operation, or sometimes even up to one year if an implant (such as a knee or hip joint implant) is used.

Infections can be minor, or occasionally they can cause a longer length of stay in the hospital, or an increased readmission rate for patients. Post-operative SSIs are the most common health care-associated infections (HAIs) in surgical patients.

The MHA has a number of practices in place to help prevent surgical site infections, including administering antibiotics to patients at a certain time before their surgery.

SSI-Prevention percentages are posted here quarterly using the following formula:

# of Hip/Knee joint replacement surgeries who received usual antibiotics within 60 min of skin incision

# of Hip/Knee joint replacement surgeries who received vancomycin within 120 min of skin incision

X 100%

Total number of patients during the reporting period who had a primary knee/hip joint replacement surgical procedure

MHA-SMGH Prophylactic Pre-operative Antibiotic Timing
Compliance Rates 2011

Quarter	Knee Arthroplasty	Hip Arthroplasty
Jan-March	91.84%	90.48%
Apr-Jun	100%	100%
July-Sept	98%	100%
Oct-Dec	100%	100%

Connecting with the Future of Care

SSI/VAP/CLI