AQI73 Prevention of Arterial Line-Related Bloodstream Infections

Measure ID

AQI73

Measure Title

Prevention of Arterial Line-Related Bloodstream Infections

Measure Description

Percentage of patients, regardless of age, who undergo placement of a peripheral intra-arterial catheter for whom the arterial line was inserted with all indicated elements of sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound techniques followed.

This measure will consist of three performance rates:

a. Percentage of patients, regardless of age, who undergo placement of a peripheral intra-arterial line in the brachial, radial, posterior tibial or dorsalis pedis artery for whom the arterial line was inserted with all indicated elements of sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound techniques followed

b. Percentage of patients, regardless of age, who undergo placement of a peripheral intra-arterial line in the femoral or axillary artery for whom the arterial line was inserted with all indicated elements of maximal sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound technique is followed

Note: The overall measure score will be calculated as an average of the total cases of part A (rate 2) and part B (rate 3). The overall measure score is rate 1.

Denominator

a. All patients, regardless of age, who undergo placement of an intra-arterial catheter in the brachial, radial, posterior tibial or dorsalis pedis artery

b. All patients, regardless of age, who undergo placement of an intra-arterial catheter in the femoral or axillary artery

Numerator

a. Patients for whom intra-arterial catheter was inserted with all indicated elements of sterile barrier technique, hand hygiene, skin preparation (including >0.5% chlorhexidine with alcohol, unless there is a contraindication to chlorhexidine), and, if ultrasound is used, sterile ultrasound techniques followed

Numerator Definitions: Sterile Barrier Technique: Includes all of the following elements: Cap AND mask AND sterile gloves AND sterile draping.
Sterile Ultrasound Techniques: Require sterile gel and sterile probe covers

b. Patients for whom intra-arterial catheter was inserted with all elements of maximal sterile barrier technique, hand hygiene, skin preparation (including >0.5% chlorhexidine with alcohol, unless there is a contraindication to chlorhexidine), and, if ultrasound is used, sterile ultrasound techniques followed

Numerator Definitions: Maximal Sterile Barrier Technique – includes all of the following elements: Cap AND mask AND sterile gloves AND sterile gown AND sterile full body draping
Sterile Ultrasound Techniques- Require sterile gel and sterile probe covers

Denominator Exclusions

None

Denominator Exceptions

a. Documentation of medical reason(s) for not following all indicated elements of sterile barrier technique, hand hygiene, skin preparation, and, if ultrasound is used, sterile ultrasound techniques during intra-arterial catheter insertion (e.g. An emergency surgical, therapeutic, or diagnostic procedure or an unanticipated worsening of the patient’s clinical condition so that adherence would cause delay in arterial line insertion resulting in increased risk of harm to patient)

b. Documentation of medical reason(s) for not following all elements of maximal sterile barrier technique, hand hygiene, skin preparation, and, if ultrasound is used, sterile ultrasound techniques during intra-arterial catheter insertion (e.g. An emergency surgical, therapeutic, or diagnostic procedure or an unanticipated worsening of the patient’s clinical condition so that adherence would cause delay in arterial line insertion resulting in increased risk of harm to patient)

Numerator Exclusions

None

NQF ID

N/A

NQS Domain

Patient Safety

High Priority Measure

Yes

High Priority Type

Patient Safety

Measure Type

Process

Telehealth

No

Meaningful Measure Area

Healthcare-associated infections

Inverse Measure

No

Proportional Measure

Yes

Continuous Variable Measure

No

Ratio Measure

No

Range of the score(s) if Continuous Variable and/or Ratio

N/A

Number of performance rates to be calculated and submitted

3

Performance Rate Description(s)

Rate 1: The overall measure score will be calculated as an average of the performance rates of part A and part B. (Rates 2 & 3)
Rate 2: Percentage of patients, regardless of age, who undergo placement of a peripheral intra-arterial line in the brachial, radial, posterior tibial or dorsalis pedis artery for whom the arterial line was inserted with all indicated elements of sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound techniques followed
Rate 3: Percentage of patients, regardless of age, who undergo placement of a peripheral intra-arterial line in the femoral or axillary artery for whom the arterial line was inserted with all indicated elements of maximal sterile barrier technique, hand hygiene, skin preparation and, if ultrasound is used, sterile ultrasound technique is followed

Overall Performance Rate

1st Performance Rate

Risk-Adjusted Status

No

Risk-Adjusted Score

N/A

Care Setting

Hospital

Additional Care Setting Information

N/A