We start with central-line and catheter infections (CLABSI and CAUTI). Every morning, Penlight finds the lines and catheters patients no longer need and shows the reason to the nurse who decides. The same routine is built to extend to other hospital-acquired infections.
An ICU nurse described it to us this way. A line goes in on Monday. The lines team is not back until Friday. If it goes bad on Wednesday, the bedside nurse has no way to say so.
The doctor orders the line, a lines team places it, and the nurse uses it. Each of them is doing the job well, and none of them is assigned to ask each day whether it still needs to be there.
Whether a device is still needed depends on medication, order and line records that sit in different parts of the EHR. Checking every device by hand, every day, takes time no unit has.
The charge nurse sees every idle line and catheter on the unit at the start of the shift, and each one ends the day with an owner, a reason and a record.
Medication, order and line records, read beside Epic. Nothing is written back.
Any central line or urinary catheter that nothing has needed for a full day, shown with the last therapy and when it stopped.
Keep the device with a reason, or send a removal request to the provider. One tap either way, and the decision is logged.
The rate hospitals are graded on divides infections by line days. Take out idle lines and the line days can fall faster than the infections, so the unit doing the right thing can look worse on the measure CMS uses.
patients infected, if every idle-day prompt were acted on
infections per 1,000 line days, in the same model
A model on past records from one hospital, 27,502 central lines. It is not a product result. Each hospital's numbers are measured on its own unit. Cutting device use "may select a higher-risk population" (Fakih, ICHE 2019, 84 hospitals). Penlight reports device days next to the infection rate, so the work shows.
"Promptly remove any intravascular catheter that is no longer essential." That is CDC's highest grade of recommendation, and the 2022 national guides add a daily check of need.
Reminders and stop orders cut urinary-catheter infections 52% in a meta-analysis of 14 studies. In one surgical ICU, a daily "is this line needed?" prompt took central-line infection from 1.8% to 0.3% of patients.
Lines our rule called idle needed a new line within 48 hours half as often as other removals, 14.5% against 28.8%, across 27,502 ICU lines.
One academic center built an idle-line list inside Epic. Removal of flagged lines within a day went from 20% to 29%, and infections did not change. Penlight is built around the routine that follows the flag.
Hospitals run infection and harm prevention as a dozen separate manual programs, each with its own bundle, owner, audit and committee, and results are measured months later by hand. Penlight is building the daily layer that runs across them.
Central lines and urinary catheters. Both rules are tested on real ICU records.
Ventilators and other devices, with the same daily question for the same nurse.
C. diff and MRSA precautions and pressure injury prevention, with an owner and a record for each step.
That was the FY2026 Hospital-Acquired Condition Reduction Program. At 223 of them, central-line or urinary-catheter infection was the weakest of the six measures.
The 2022 NHSN baseline is expected to drive the penalty from FY2028, and 2025 to 2026 performance is what counts. Hospitals that look fine on the 2015 baseline may not.
More than 15 conversations with ICU nurses and nurse leaders shaped what you see here. Dressing integrity became a first-class flag, removal authority became configurable for each hospital, and a provider request became a queue with a record.
A read-only SMART on FHIR connection. Penlight reads the chart and never writes to it.
Each prompt shows the rule and the record behind it, so a clinician can see why a device came up and disagree.
Device days per patient day and removal within 24 hours, reported next to the infection rate.
If you work in an ICU, infection prevention, vascular access or quality, we want your judgment on how this should work on a real unit. We can walk you through it on a short call.
Rabiya earned her MPH at Columbia, where she reviewed 44 studies on hospital infection control. She has charted in Epic at the bedside, ran more than 30 county health partnerships at Curative, and built Penlight, including the study of 27,502 central lines behind this page.