{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,16]],"date-time":"2026-06-16T16:57:39Z","timestamp":1781629059765,"version":"3.54.5"},"reference-count":31,"publisher":"Cambridge University Press (CUP)","issue":"1","license":[{"start":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T00:00:00Z","timestamp":1573171200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2020,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X19002915_as1\"><jats:title>Objective:<\/jats:title><jats:p>To assess the impact of a newly developed Central-Line Insertion Site Assessment (CLISA) score on the incidence of local inflammation or infection for CLABSI prevention.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002915_as2\"><jats:title>Design:<\/jats:title><jats:p>A pre- and postintervention, quasi-experimental quality improvement study.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002915_as3\"><jats:title>Setting and participants:<\/jats:title><jats:p>Adult inpatients with central venous catheters (CVCs) hospitalized in an intensive care unit or oncology ward at a large academic medical center.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002915_as4\"><jats:title>Methods:<\/jats:title><jats:p>We evaluated CLISA score impact on insertion site inflammation and infection (CLISA score of 2 or 3) incidence in the baseline period (June 2014\u2013January 2015) and the intervention period (April 2015\u2013October 2017) using interrupted times series and generalized linear mixed-effects multivariable analyses. These were run separately for days-to-line removal from identification of a CLISA score of 2 or 3. CLISA score interrater reliability and photo quiz results were evaluated.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002915_as5\"><jats:title>Results:<\/jats:title><jats:p>Among 6,957 CVCs assessed 40,846 times, percentage of lines with CLISA score of 2 or 3 in the baseline and intervention periods decreased by 78.2% (from 22.0% to 4.7%), with a significant immediate decrease in the time-series analysis (<jats:italic>P<\/jats:italic> &lt; .001). According to the multivariable regression, the intervention was associated with lower percentage of lines with a CLISA score of 2 or 3, after adjusting for age, gender, CVC body location, and hospital unit (odds ratio, 0.15; 95% confidence interval, 0.06\u20130.34; <jats:italic>P<\/jats:italic> &lt; .001). According to the multivariate regression, days to removal of lines with CLISA score of 2 or 3 was 3.19 days faster after the intervention (<jats:italic>P<\/jats:italic> &lt; .001). Also, line dwell time decreased 37.1% from a mean of 14 days (standard deviation [SD], 10.6) to 8.8 days (SD, 9.0) (<jats:italic>P<\/jats:italic> &lt; .001). Device utilization ratios decreased 9% from 0.64 (SD, 0.08) to 0.58 (SD, 0.06) (<jats:italic>P<\/jats:italic> = .039).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X19002915_as6\"><jats:title>Conclusions:<\/jats:title><jats:p>The CLISA score creates a common language for assessing line infection risk and successfully promotes high compliance with best practices in timely line removal.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2019.291","type":"journal-article","created":{"date-parts":[[2019,11,8]],"date-time":"2019-11-08T09:46:59Z","timestamp":1573206419000},"page":"59-66","source":"Crossref","is-referenced-by-count":12,"title":["Impact of a Central-Line Insertion Site Assessment (CLISA) score on localized insertion site infection to prevent central-line\u2013associated bloodstream infection (CLABSI)"],"prefix":"10.1017","volume":"41","author":[{"given":"Shruti K.","family":"Gohil","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jennifer","family":"Yim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Quan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurice","family":"Espinoza","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah J.","family":"Thompson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allen P.","family":"Kong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bardia","family":"Bahadori","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom","family":"Tjoa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Paiji","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Scott","family":"Rudkin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syma","family":"Rashid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suzie S.","family":"Hong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Dickey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamad N.","family":"Alsharif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alpesh N.","family":"Amin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Usme","family":"Khusbu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan S.","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2019,11,8]]},"reference":[{"key":"S0899823X19002915_ref12","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir138"},{"key":"S0899823X19002915_ref31","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-200212000-00003"},{"key":"S0899823X19002915_ref27","volume-title":"Principles and Practice of Infectious Diseases","author":"Bayer","year":"2000"},{"key":"S0899823X19002915_ref26","doi-asserted-by":"publisher","DOI":"10.1155\/2019\/9810675"},{"key":"S0899823X19002915_ref22","first-page":"44","article-title":"Clinical utility of the Braden scale for predicting pressure sore risk","volume":"2","author":"Braden","year":"1989","journal-title":"Decubitus"},{"key":"S0899823X19002915_ref21","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0b013e31823e9f5b"},{"key":"S0899823X19002915_ref18","doi-asserted-by":"publisher","DOI":"10.1086\/591059"},{"key":"S0899823X19002915_ref17","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2009.420"},{"key":"S0899823X19002915_ref19","doi-asserted-by":"publisher","DOI":"10.1086\/340105"},{"key":"S0899823X19002915_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2016.32"},{"key":"S0899823X19002915_ref10","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cir257"},{"key":"S0899823X19002915_ref9","unstructured":"9. 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