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This chapter provides information on practices organizations can follow to monitor CLABSIs, measurement approaches to take in assessing central venous catheter insertion and maintenance practices, and public reporting of infection rates and pay-for-performance programs. 

Key points include the following:

• Surveillance for health care-associated infections (HAIs), including CLABSIs, is a necessary first step in defining the nature and magnitude of the problem in any infection prevention and control program. Surveillance involves systematically collecting, analyzing, interpreting, and disseminating data to members of the health care team as a means to facilitate improvement in patient outcomes.

• Surveillance activities for HAIs, including CLABSI, should be based on the results of an organizational risk assessment, as each organization serves different types of patients at varying levels of risk.

• Approaches to surveillance that both save time and facilitate efficient review of relevant data include prevalence surveys and electronic surveillance systems.

• Specific outcome measures (for tracking rates) and process measures (to determine adherence to recommended practices) should be identified in individual organizations, based on areas that have been identified for performance improvement.

• Public reporting of outcome measures can promote transparency, allow consumers to seek health care in safer organizations, and provide an incentive to improve care. In many US states, reporting of HAI rates is now required by law.