Bloodstream Infection Paper

Article by Clancy (2009) explained central lines were a result of an estimated 250,000 blood stream infections and accounted for 30,000 to 62,000 patient deaths, then adding that each infection cost upwards of $36,000 and cumulatively add up to at least $9 billion in preventable costs annually. The article also explains how the mindset has changed from the cost of having a central line in place and expecting complications to lowering infection rates by an intentional interventional process/s. The article speaks of 5 basic steps to reduce CLABSI, hand washing, insertion techniques, skin cleansing, avoidance of certain sites and earlier removal of the CVC. Studies showed that these guidelines were only followed 62% of the time. The system was changed to ascertain that all the clinicians were in compliance. This prompted 5 interventions, education, a CVC insertion cart with all necessary equipment, physicians having to validate central line necessity, a concise checklist for bedside clinicians and the empower of nurses to stop procedures if guidelines were not followed. These low cost interventions from 11.3/1000 in catheter days in 1998 to zero in the fourth quarter of 2002.

Central line bundle is a group of evidence-based practice strategy for patient with central catheters, when implemented together, produce better outcomes than implemented individually (Institute of health care improvement, 2010.). The main elements of central line bundle are hand hygiene, maximal barrier precaution upon insertion, Chlorhexidine skin antisepsis, optimal catheter selection, and daily review of line necessity with prompt removal of unnecessary lines Aseptic technique when using and caring for a central line catheter can decrease the chance of contamination in this critically ill infants. Staff education on adherence to aseptic technique and strict central line care guidelines are essential to decreasing bloodstream infections.

For instance, there are many different types of infections that occur in the intensive care unit (ICU), as well as various methods of prevention that patients, visitors, providers, and other hospital staff can practice. Of the many different types of infections that occur in these critically ill patients, catheter-associated urinary tract infections (CAUTIs) and central line-associated bloodstream infections (CLABSIs) are two of the most serious infections, and they also happen to be the most

The CDC’s National Healthcare Safety Network (NHSN) supports 2,000 hospitals nationally (Central line-associated bloodstream infections, n.d.). Since March 2010, hospitals, in twenty one of the United States’ fifty states, are required to report their hospital acquired infections to the NHSN (Central line-associated bloodstream infections, n.d.). The CMS data report includes identification numbers for the hospitals the CLABSI happened at, the name and address of the hospitals, the number days the central line was in, the number of CLABSI incidences the hospitals had, and each hospitals’ National Healthcare Safety Network standardized infection ratio (SIR) (Tabak et al.,

An intervention was done in a surgical intensive care unit to reduce the incidence of central line-associated bloodstream infections. The method of intervention was to create and utilize central line insertion and maintenance bundles. The hope, was that if all of the supplies needed were bundled together, then clinicians would use them appropriately. The maintenance kit included hand hygiene, catheter site dressing, hub care, and a daily review of the necessity of the line. The hub care consisted of 70% alcohol. Creation of the bundles, and training on how to use them, was done through the nurses and doctors on staff. There were regular in services held where nurses would teach how to utilize the kits. These

ReferencesBarrett , S. P. (2005). What's new in infection control? Medicine Publishing Company,33(3), i-iii. Retrieved July 5, 2006, from http://www.atyponlink.com/MPC/doi/abs/10.1383/medc.2005.33.3.iBebbington, A., Parkin, P.A., Chichester, L. J., & Kubiak, E. M. (2003). Patients'case notes: look but don't touch. Journal of Hospital Infection. 55, (4).

To simplify central line care, the Joint Commission released their five easy and proven interventions to keep CLABSIs at bay, essentially streamlining the IHI’s recommendations. The five interventions include: thoroughly utilizing appropriate hand hygiene, chlorhexidine skin preparation, and full barriers during insertion, avoidance when possible of utilizing the femoral approach, and a primary focus on removing unnecessary central lines. This last intervention is crucial with central lines as each day that a patient has a central line in place, the higher risk they have of developing a CLABSI. When looking at this intervention it is critical to have a team that can make daily or weekly at the minimum, line rounds to assess the line and determine if the line is still medically necessary. It is imperative that this team is able to have an open communication with the doctor in order to recommend and request the line be removed. Central line teams found in hospitals have proven to be yet another effective measure at controlling CLABSIs. However, still nothing has been effective enough to reach the zero event goal set forth. (The

Central lines are a one of the major risk factors for infections in the bloodstream and many occur outside of the intensive care units (Medina, Serratt, Pelter, & Brancamp, 2014). An increase in the amount of patients who are admitted to the hospital with central lines has increased the amounts of central line infections. Reducing the amount of central line infections on a general Medical-Surgical unit with in a facility is very important for both patients and healthcare facilities.

Hospital acquired infections (HAIs) have been a topic of concern. Urinary catheters place patients at risk for these infections. HAIs cost approximately 9.8 billion dollars annually; However, Catheter associated urinary tract infections (CAUTIs) are less than 1% of that total (Waknine, 2013). None the less, steps must be taken to prevent CAUTIs. Some of the advantages of preventing/reducing CAUTIs is improved patient outcomes and a reduction in the facility’s costs of treating HAIs. There is some complexity in implementation of your solution, for example, increase in nursing assessment, treatment, documentation, and patient education. When there is an increase in the complexity of a solution, nurses will be more resistance to change. Thank

The team reinforced teaching on proper changing of central line dressing and management, observed nurses techniques as well as implemented the weekly change of the needle-free system caps. The dressing change technique uses “proper hand-washing, donning of masks, proper cleansing with ChloraPrep (chlorhexidine gluconate and isopropyl alcohol skin preparation), correct dressing (Biopatch) placement, and application of occlusive dressing (IV3000).” (Cooney-Newton, 2015) This resulted in CLABSI rates reducing by 50% for two years following the

Another article which also supported the idea of preventing infection by the use of antimicrobial catheter was “The Influence of an Antimicrobial Peripherally Inserted Central Catheter on Central Line-Associated Bloodstream Infections in a Hospital Environment” by Glenell S. Rutkoff, MSN, RN, CGRN. This research included 2 groups consisting of 260 patients each. The nonintervention group included adult, hospitalized patients who received an unprotected single- or dual lumen PICC during a 6-month period. The intervention group included adult, hospitalized patients who had the study antimicrobial PICC placed during a 6-month period. This study found that the 2 groups were not significantly different when they were compared using c2 for homogeneity of age, gender (P ¼ .09), ethnicity (P ¼ .047), and unit (P ¼ .01). There was a statistically significant decrease in the rate of CLABSI from 4.18/1,000 catheter days to 0.47/1,000 catheter days when the antimicrobial PICC was used. With the information provided by both of these research articles it can be concluded that the implementation of antimicrobial and antibiotic use in central lines, diminishes the risk for infection (Rutkoff, 2014).

Based on a study in the International Journal of Nursing Studies, the use of antiseptic barrier caps had be found to reduce the occurrences of central line associated infections with a P <0.001. The use of an antiseptic barrier cap would reduce the steps in a procedure to prevent infection, as the catheter hub would not have to be meticulously cleaned, instead the cap could kill bacteria without needing any extra work. As the use of these caps has been proven effective in preventing infection, they could be extremely helpful in including in our new infection prevention procedure for developing countries, as it would reduce a step in the process, and provide further

Great job you nurses are doing at your unity. Central line associated blood stream infection (CLABSI) is one of the major problems most hospitals are experiencing. As explained by Boubekri, (2013) health care associated infections are a measure problem in most hospital and about 70% are from centrals lines. An effort put in place at my hospital was the use of chlorhexidine (CHG) wipes, we use them daily with patients that have a central line, wiping the daily around the central line side to reduce infection. Boubekri went further to explain in the article that the use of CHG wipe daily reduce the CLABSI. We use the CHG wipes on patients going for surgery, patients on Foley catheter, and any invasive procedure. It has really helped to reduce

During the times of high compliance, nosocomial infections decreased in several instances. This shows that proper hand hygiene is directly linked to occurrences of nosocomial infections. Intervention materials are readily available through various websites, which include Power Point presentations, handouts, and many multi-modal learning applications that can be accessed at any time. Healthcare facilities should consider making them an ongoing priority to keep the reduction of the nosocomial infections

The use of central venous catheters (CVCs) are integral to modern healthcare and have become an increasingly common means of administering treatments that vary from intravenous fluids to blood products to life-saving medications (Sacks et al., 2014; Oto, Imanaka, Konno, Nakataki, & Nishimura, 2011; The Joint Commission, 2012). The use of CVCs allows for immediate vascular access and improved patient comfort as a result of the decreased need for multiple needle sticks. However, their use is associated with an increased risk of blood stream infections. These infections called central-line associated bloodstream infections (CLABSIs) cause significant morbidity, mortality, and increased health care costs (Ramirez, Lee, & Welch, 2012; Sacks et al., 2014; Sandora et al., 2014 Wright et al., 2013; The Joint Commission, 2012).