{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T19:50:08Z","timestamp":1790193008153,"version":"4.1.0"},"reference-count":28,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T00:00:00Z","timestamp":1738540800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2025,3]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0899823X24002034_as1\"><jats:title>Objectives:<\/jats:title><jats:p>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).<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002034_as2\"><jats:title>Design:<\/jats:title><jats:p>Pre-post prospective cohort study with baseline (September 2015\u2013December 2016), phase-in (January 2017\u2013April 2017), and intervention (May 2017\u2013December 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.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002034_as3\"><jats:title>Setting:<\/jats:title><jats:p>Six nursing homes in Orange County, California.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002034_as4\"><jats:title>Patients:<\/jats:title><jats:p>Adult nursing home residents with PICCs.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002034_as5\"><jats:title>Intervention:<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002034_as6\"><jats:title>Results:<\/jats:title><jats:p>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\u20130.64, <jats:italic>P<\/jats:italic> &lt; .001), 73% lower local inflammation\/infection (OR = 0.27, 95% CI: 0.13\u20130.56, <jats:italic>P<\/jats:italic> &lt; .001), and 41% lower risk of infection-related hospitalizations (OR = 0.59, 95% CI: 0.42\u20130.83, <jats:italic>P<\/jats:italic> = .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\u20130.62, <jats:italic>P<\/jats:italic> &lt; .001) and 95% faster removal of infected lines from mean (<jats:sc>SD<\/jats:sc>) 19 (20) to 1 (2) days.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X24002034_as7\"><jats:title>Conclusions:<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2024.203","type":"journal-article","created":{"date-parts":[[2025,2,3]],"date-time":"2025-02-03T06:39:27Z","timestamp":1738564767000},"page":"236-242","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":2,"title":["A telehealth approach to central line-associated bloodstream infection prevention activities in nursing homes: the SAFER lines program"],"prefix":"10.1017","volume":"46","author":[{"given":"Raveena D.","family":"Singh","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7314-2988","authenticated-orcid":false,"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":"Mohamad N.","family":"Alsharif","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shereen","family":"Nourollahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin","family":"Chang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2131-4060","authenticated-orcid":false,"given":"Amarah","family":"Mauricio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Bethlahmy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syma","family":"Rashid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raheeb","family":"Saavedra","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabel Y.","family":"Ashbaugh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Steven","family":"Tam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1932-7540","authenticated-orcid":false,"given":"Shruti K.","family":"Gohil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2025,2,3]]},"reference":[{"key":"S0899823X24002034_ref20","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.1999.tb01903.x"},{"key":"S0899823X24002034_ref1","doi-asserted-by":"publisher","DOI":"10.1017\/ice.2015.115"},{"key":"S0899823X24002034_ref13","unstructured":"13. 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