2 In 2008, as a response to the American epidemic of HAIs, the
Centers for Medicare and Medicaid Services created new rules denying hospital reimbursement
for costs associated with conditions not present on admission.3 Central line–associated
bloodstream infections (CLABSIs) are listed as 1 of the 10 conditions not eligible for reimbursement.4
Compared with other HAIs, CLABSIs are associated with the highest mortality
among patients in intensive care units (ICUs).5 According to current publications, many hospitals
have implemented quality-improvement strategies in the ICU to decrease estimates of
CLABSI prevalence as high as 20% to 30%,6,7 the up to $40 000 cost associated with each
CLABSI occurrence,8,9 and ultimately the mortality rates (some reported as high as 25%).