Hostname: page-component-7b7567c8c-2rsb6 Total loading time: 0 Render date: 2026-11-12T20:17:12.982Z Has data issue: false hasContentIssue false

How Low is Low Enough? Determining a Goal Central Line Standardized Utilization Ratio Necessary to Decrease Infections

Published online by Cambridge University Press:  23 June 2026

Abstract

Core share and HTML view are not available for this content. However, as you have access to this content, a full PDF is available via the 'Save PDF' action button.

Background: One intervention to decrease central line associated bloodstream infections (CLABSI) standardized utilization ratios (SIR) is to decrease use of central lines. Central line use can be measured using the standardized utilization ratio (SUR), calculated by the National Healthcare Safety Network (NHSN). Unlike the SIR, decreasing the SUR all the way to zero is not an achievable goal; some patients need to have a central line for their treatment. The objective of this project was to identify a target SUR value to help reach SIR goals. Methods: A midwestern healthcare system set their CLABSI SIR goal at 0.5. Using paired SUR and SIR data from 6 large hospitals from July 2019 through February 2025, six machine learning methods (4 parametric, 2 non-parametric) were applied to determine the SUR required to achieve the goal SIR. The six individual model–recommended SUR values were combined using bootstrap resampling: drawing 1,000 samples (with replacement) from the six SUR estimates, computing the mean each time to produce an ensemble recommendation, and then taking the 5th and 95th percentiles of those means as a 90% confidence interval. Results: Over the study timeframe, the aggregated system SUR was 0.742 and aggregated SIR was 0.774 . The comprehensive analysis recommended that the system adopt an SUR target of 0.650 (90% Confidence Interval: 0.645–0.655) to achieve the central line SIR goal (Figure 1). Conclusion: The analysis allowed the healthcare system to set a personalized goal, using data from the member hospitals, for SUR performance. This allowed identification of hospitals that needed to focus on further interventions to decrease central line use, versus those that should pivot their CLABSI prevention interventions to other focuses.

A scatter plot showing the relationship between standardized utilization ratio and standardized infection ratio.

Information

Type
CLABSI
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2026. Published by Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America