Prioritizing Interventions to Prevent CLABSI: Insights for Future Research

Central line-associated bloodstream infections (CLABSIs) are among the most serious complications of central venous access devices (CVADs), causing harm to patients and burdening health systems. Despite multiple strategies for prevention, few are supported by strong randomized trial evidence. This study identified key priorities for testing in the upcoming IVCare adaptive platform trial.

Study Overview
A prioritization exercise was conducted among 65 infection prevention clinicians attending an Australasian workshop. Participants ranked 17 potential interventions drawn from the 2022 SHEA CLABSI prevention guidelines, focusing on strategies lacking robust evidence or targeting high-risk populations. The goal was to identify feasible, high-impact interventions for inclusion in the IVCare trial.

Key Findings
Top priorities for trial testing:

• Education and competency assessment for CVAD insertion and care
• Infusion therapy/vascular access teams
• Sutureless securement devices
• Antiseptic-containing hubs/connectors
• Mechanical decontamination of catheter access points
• No intervention was consistently used across hospitals, confirming clinical equipoise.
• Respondents highlighted the need for cluster randomization and investment in training and resources to support these interventions.

Conclusion
This study provides clear guidance for designing the IVCare adaptive platform trial, emphasizing interventions at both the workforce and patient care levels. The findings highlight a need for high-quality evidence to standardize CLABSI prevention strategies and drive safer vascular access practices.

Read more:https://www.ajicjournal.org/article/S0196-6553(25)00411-0/fulltext  

Authors: Claire M. Rickard, Andrew J. Stewardson, Sally M. Havers, Karina R. Charles, Jessica A. Schults, on behalf of the IVCare Trial Study Group