Clabsi And Clabse Infection

PICC lines, or peripherally inserted central catheters, are a convenient healthcare treatment. A PICC line is a thin catheter that is inserted in the large veins near your forearm at the flex point. It can be inserted by a physician or by a specially trained nurse and is minimally invasive. People who can get PICC lines include "patients who have to receive IV therapy longer than five days, when there is difficulty maintaining peripheral access, for any infusions known to damage the inside of the vein, for infusion of total parenteral nutrition, patients with respiratory ailments that increase risk for using other central venous access devices, for patients receiving chemotherapy, and for any patients needing prolonged outpatient treatment that requires use of an IV." http://www.cpmc.org/learning/documents/nur-piccline-ws.pdf. I am going to further discuss how a PICC line is inserted, the benefits and the risks, safety of PICC lines, and caring for a PICC line.

It can also occur during blood transfusion or during dressing change. The insertion of central catheters can occur in the Interventional Radiology or sometimes at the bedside. Regardless of the where the insertion process occur, a sterile field must always be maintained and sterile techniques must always be employed to prevent any organisms from being introduced to the central line into the patient. According to The Joint Commission (2013), many organizations such as Michigan Keystone Intensive Care Unit Project and Institute for Healthcare Improvement are actually adhering to insertion bundles to reduce the CLABSI rates. The bundles include hand hygiene, maximal barrier precautions, chlorhexidine skin preparation, avoidance of femoral vein, and prompt removal of central catheter. Furuya et al. (2011) studied the effectiveness of the insertion bundle and how it impacts the bloodstream infections for patients in the Intensive Care Unit. As a result, lesser infection have occurred when the compliance is high. As mentioned, the site of the catheter also needs to be considered in the insertion process. Avoiding areas such as the groin to access the femoral artery is recommended because this area can be easily contaminated with urine or feces. In addition, after the insertion of a new central line, all the used IV tubing

Getting an infection from improper care during or after insertion of a central line is the last thing you want to get while in the hospital. This paper will discuss Kaiser Permanente’s policy on central venous catheter, also known as a central line, care and dressing change, and whether it follows the current evidence-based practice on preventing bloodstream infection in patients who have them inserted. I will explain about what a central line is, why evidence-based practice is important in the clinical setting, what Kaiser Permanente’s policy about central line care and dressing change is, if Kaiser is currently following evidence-based practice based on current articles about preventing central line associated bloodstream infections (CLABSIs), and what my role in using evidence-based practice is as a future registered nurse.

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.

One of the ways to combat the incidence of Central Line Associated Bloodstream Infection (CLABSI) is by following the proper steps in Central Line Dressing changes. The topic you picked is an important one, both for patients and our overall health care system as well. If nurses will learn, and follow the proper manner in the way Central Venous Lines should be changed it can have a positive outcome for patients. CLABSI can be fatal to the patient, this can devastate the patient's family as well. “Although a 46% decrease in CLABSIs has occurred in hospitals across the U.S. from 2008-2013, an estimated 30,100 central line-associated bloodstream infections (CLABSI) still occur in intensive care units and wards of U.S. acute care facilities each

The purpose of this initiative is to decrease and/or eliminate central line-associated bloodstream infections (CLABSI) in the neonatal intensive care unit (NICU) at Aurora Bay Care Medical Center. Hospital acquired infections, including CLABSI, is a major cause of mortality, prolonged hospitalization, and extra costs for NICU patients (Stevens & Schulman, 2012). The goal of this initiative is to decrease CLABSI by 75% by reducing the number of days lines are in and standardizing the insertion process and line maintenance.

The IC department performs about 20 reviews a quarter utilizing the Bloodstream surveillance checklist tool to monitor for PICC/Central Line compliance. Hand sanitizer rewards are now being given to staff that has 100% in the process measure to increase CLABSI compliance. Our facility is engaged in the Hospital Improvement and Innovative Network (HIIN) formerly the Maryland-Virginia HAI Improvement Network is the hospital-wide collaborative to reduce CLABSIs. This 5-year initiative is an affiliation of the Medicare Quality Innovation Network Quality Improvement Organization for Maryland and Virginia, through Centers for Medicare & Medicaid Services (CMS). The initiative offers support efforts to improve health care quality and achieve

There have been many studies documented in the literature regarding the reduction of CLABSIs. The majority of the studies have reported statistically significant decreases in CLABSI rates post-implementation of a quality improvement initiative (O‟Grady et al., 2011). Some studies used approaches in which multiple strategies have been implemented together to improve compliance with the use of evidence-based guidelines. A seminal study conducted by Pronovost et al. (2006), known as the Keystone ICU project, included a collaborative cohort of 108 ICUs within the state of Michigan. The strategies in this study included the use of five evidence-based bloodstream infection prevention practices for CVC insertions, use of a checklist to ensure adherence

The use of disinfecting Curos™ caps must be a routine practice on all oncology floors. This change can readily be implemented, as it does not take much training to learn how to use. The Curos™ caps should also be implemented already existing CLABSI prevention bundles. Considering the 12-25% high mortality rates of CLABSI, implementing the disinfecting caps could reduce the rates of CLABSI by as much as 66% (Whitfield& Lowe, 2013). According to Ramirez, Lee, & and Welch(2014) “ During 2010,the CLABSI rate reduced from 1.9 to 0.5 per 1,000 catheter days during a one-year trial period. Furthermore, compliance to CLABSI prevention bundles increased from 63% to 80% when implementing the disinfecting Curos ™ caps. This high

Healthcare-associated infections from invasive medical devices are linked to high morbidity, mortality, and costs worldwide. Especially in central line–associated bloodstream infection (CLABSI) or catheter-related bloodstream infection (CRBSI) and

Catheter associated bloodstream infection (CRBSI) occurring in the neonatal intensive care unit (NICU) are frequent, complication related to it are potentially fatal and costly (Kim & Sandra, 2009). According to the center of disease control, an approximate of two hundred and fifty thousand cases of CRBSIs have been estimated to occur annually which cause health care to cost approximately twenty five thousand dollars per case, and between 500 to 4,000 patient die due to blood stream infection (CDC, 2002). Approximately 90 percent of blood stream infection occurs from central venous insertion (CVC). Even though CRBSI occurs from different ways, the most common source is contamination of the catheter by skin flora on insertion, skin flora

The ICUs are associated with over 15 million catheter days while there is indication that only 24.4% of CVC use occurs outside the ICUs (Chopra, Krein, Olmsted, Safdar & Saint, 2013). This implies that millions of patients in the ICUs are at a high likelihood of developing CLABSI

There were several dependent variables which were significant predictors of complications. First females older than 70 with HTN and renal failure were identified. Second the presence of a venous sheath was found to be an important indicator and finally female gender with a high BMI stood out as well for a higher complication

Device infections in CIED surgery is a serious and potentially lethal complication. The management of CIED infections remains a challenge, and complete device removal is the only effective measure for eradication of CIED infections.2 Several risk factors have been investigated and shown to contribute to overall increased risk of CIED

Article reference (in APA style): Sofroniadou, S., Revela, I., Smirloglou, D., Makriniotou, I., Zerbala, S., Kouloubinis, A., & ... Iatrou, C. (2012). Linezolid versus Vancomycin Antibiotic Lock Solution for the Prevention of Nontunneled Catheter-related Blood Stream Infections in Hemodialysis Patients: A Prospective Randomized Study. Seminars In Dialysis, 25(9), 344-350. doi:10.1111/j.1525-139X.2011.00965.x