{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T10:45:41Z","timestamp":1791801941836,"version":"4.3.4"},"reference-count":18,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T00:00:00Z","timestamp":1791763200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Infect. Control Hosp. Epidemiol."],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec id=\"S0899823X26105649_as1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Under current National Healthcare and Safety Network (NHSN) methodology for CLABSI reporting, patients with multiple, concurrent central lines are counted as one line day, potentially underestimating true central line exposure.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105649_as2\">\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To evaluate the impact of NHSN central line reporting guidelines on CLABSI rates, benchmarking, and quality improvement outcomes across a multi-hospital health system.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105649_as3\">\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>Retrospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105649_as4\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Electronic health record (EHR) data was collected for 7,645 inpatients across three adult acute care and one pediatric acute care hospital from January 2024 through December 2024. Additional data from the academic medical center\u2019s intensive care units (ICU) was collected from January 2025 to July 2025. Reported and actual central line days were compared across hospitals and care settings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105649_as5\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Actual line days totaled 113,529 compared to 90,789 reported line days with significantly different proportions across hospitals (P &lt; .001). The reduction in CLABSI rate calculation when using actual line days was largest at higher-acuity settings, with the academic medical center ICUs demonstrating a decrease from 1.54 to 1.03 per 1,000 line days, a 33% reduction. Evaluation of a quality improvement initiative revealed significant improvement across all three ICUs when using actual line days, compared to only two ICUs under reported data alone.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"S0899823X26105649_as6\">\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Current NHSN reporting methodology systematically underestimates central line exposure at higher-acuity hospitals, impacting CLABSI benchmarking and obscuring quality improvement initiatives. Health systems should consider monitoring both reported and actual line days when evaluating performance or the impact of quality improvement initiatives.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1017\/ice.2026.10564","type":"journal-article","created":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:58:15Z","timestamp":1791799095000},"page":"1-7","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["NHSN central line day methodology: impact on CLABSI rates, benchmarking, and quality improvement across a multi-hospital health system"],"prefix":"10.1017","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7109-9772","authenticated-orcid":false,"given":"Christopher Allen","family":"Linke","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/03e1ayz78","id-type":"ROR","asserted-by":"publisher"}],"name":"University of Minnesota Medical Center Fairview: M Health Fairview University of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7799-5930","authenticated-orcid":false,"given":"Zoe","family":"Gerber","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical Center Fairview: M Health Fairview University of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-6148-4001","authenticated-orcid":false,"given":"Lauren","family":"Witty","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical Center Fairview: M Health Fairview University of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Balz","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical Center Fairview: M Health Fairview University of"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3248-5738","authenticated-orcid":false,"given":"Kathryn","family":"Pendleton","sequence":"additional","affiliation":[{"name":"University of Minnesota Medical Center Fairview: M Health Fairview University of"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2026,10,12]]},"reference":[{"key":"S0899823X26105649_ref15","unstructured":"15. Project Jupyter. Jupyter Notebook. Version 7.2.2. Project Jupyter, 2023. https:\/\/jupyter.org. Accessed April 27, 2026."},{"key":"S0899823X26105649_ref9","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2012.02.034"},{"key":"S0899823X26105649_ref1","unstructured":"1. Centers for Disease Control and Prevention. Bloodstream infection event (central line-associated bloodstream infection and non-central line associated bloodstream infection). National Healthcare Safety Network (NHSN) Patient Safety Component Manual, Chapter 4, 2026. https:\/\/www.cdc.gov\/nhsn\/pdfs\/pscmanual\/4psc_clabscurrent.pdf. Accessed April 4, 2026."},{"key":"S0899823X26105649_ref6","doi-asserted-by":"publisher","DOI":"10.1086\/677634"},{"key":"S0899823X26105649_ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajic.2010.07.012"},{"key":"S0899823X26105649_ref16","unstructured":"16. Anaconda, Inc, Anaconda Distribution. Version 23.7.4. Anaconda, Inc, 2023. https:\/\/www.anaconda.com. 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National Healthcare Safety Network (NHSN), 2022. https:\/\/www.cdc.gov\/nhsn\/pdfs\/validation\/2022\/2022-nhsn-iv-for-facilities-508.pdf. Accessed April 27, 2026."},{"key":"S0899823X26105649_ref3","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a113990"},{"key":"S0899823X26105649_ref4","doi-asserted-by":"publisher","DOI":"10.1016\/0196-6553(91)90157-8"},{"key":"S0899823X26105649_ref13","unstructured":"13. American Hospital Association. New analysis shows hospitals improving performance on key patient safety measures surpassing pre-pandemic levels (Appendix), 2024. https:\/\/www.aha.org\/guidesreports\/2024-09-12-new-analysis-shows-hospitals-performance-key-patient-safety-measures-surpassing-pre-pandemic-levels. Accessed April 27, 2026."},{"key":"S0899823X26105649_ref17","unstructured":"17. Minitab Inc. Minitab. Version 22.2.1. State College, PA: Minitab Inc; 2026,"}],"container-title":["Infection Control &amp; Hospital Epidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0899823X26105649","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,12]],"date-time":"2026-10-12T09:58:18Z","timestamp":1791799098000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0899823X26105649\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,12]]},"references-count":18,"alternative-id":["S0899823X26105649"],"URL":"https:\/\/doi.org\/10.1017\/ice.2026.10564","relation":{},"ISSN":["0899-823X","1559-6834"],"issn-type":[{"value":"0899-823X","type":"print"},{"value":"1559-6834","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,12]]},"assertion":[{"value":"\u00a9 The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}