Clabsi

Catheter related bloodstream infections are not only responsible for prolonged hospital stays and increased hospital costs, it is also responsible for increased mortality of the hospitalized patients. According to Centers for Disease Control and Prevention (2017), an estimate of 30,100 central line-associated bloodstream infections (CLABSI) occur in intensive care units and wards of U.S. acute care facilities each year. CLABSI is a serious hospital-acquired infection that occurs when bacteria enters the bloodstream through central venous catheters. CLABSI is preventable as long as health-care personnel practice aseptic techniques when working with the catheter. A blood culture swabbed from the tip of the catheter is needed to confirm the

1) Summary of Article: Indwelling catheter use is common, but so are infections associated with them. About 80 percent of all urinary tract infections in hospitals are caused by catheters, and about 20 percent of all hospital infections total are UTIs. Evidence-based practice should be used for insertion, maintenance, and removal. Catheters should not be left in longer than they need to be. Unfortunately, this research shows poor administrative efforts are to blame for

In 2013, a magnet recognized hospital, Baptist Health Lexington, reduced CAUTI rates in ICU patients by 60% (Roser, Piercy & Altpeter, 2014). The study included six interventions that were followed by the staff in the effort to reduce CAUTI. The six interventions included: “communication of CAUTI data to interdisciplinary teams, a nurse-driven, physician approved protocol, problem analysis using Lean principles, daily unit-based surveillance rounds, silver alloy urinary catheters, and an antimicrobial bundle comprised of two cleansing products for patients with an indwelling urinary catheter” (Roser, Piercy & Altpeter, 2014). The nurse-physician protocol allowed for nurses to assess whether the catheter was still necessary and if found not to be, the nurse could discontinue it. This resulted in a 58% decrease in the number of catheters used (Roser, Piercy & Altpeter, 2014). An education session was implemented by nurses using principles from the Lean system that checked the capability of nurses to understand just how dangerous CAUTI can be. It was found that no single intervention alone could reduce the occurrence of CAUTI development. Nurses must integrate several interventions to have an effective result at lowering the rates. However, this particular study found that after the use of the antimicrobial bundle, rates of CAUTI did decline. Roser et al. (2014) emphasized that education and awareness of

National Patient Safety Goals (NPSGs), established in 2002 by the Joint Commission, is to help accredited organizations address specific areas of concern in regard to patient safety ("Catheter-Associated," 2015). NPSG.07.06.01 Implement evidence-based practices to prevent indwelling catheter-associated urinary tract infections (CAUTI) is a 2015 NPSG ("The Joint Commission," 2015). Our facility has 1.32 CAUTIs per 1000 device days (Carson, 2015). Decreasing CAUTIs can be achieved with a strict goal, addressing the financial implications, interdisciplinary collaboration, nursing leadership, a measurement tool, and discussing the future healthcare delivery methods.

Patient safety and hospital acquired infections (HAI) are deemed highly important in the health care setting. My organization uses quality indicators pulled from EPIC, which is our health information system, to ensure we are meeting regulations for catheter associated urinary tract infections (CAUTI). Data includes rates of infections, length of foley catheter placement, reasons for foley placement, as well as facility specific documentation that is used to aide in the prevention of CAUTI. By pulling this data, one could identify trends affecting rate of infections. This may lead to a change in policy or procedure that can improve the rate of infections for those patients with foley catheters. Thus decreasing the percentage of HAI’s for

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.

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.

Prevent Bloodstream infections associated with Central lines: The goal is to educate staff about such infections during the hiring process and throw-out their employment in the facility. Implement the use of disinfection in the

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

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

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.

As the CEO of a hospital with the highest Central-Line Associated Blood Stream Infections (CLABSI), I am approaching the problem from an evidence-based standpoint. My first step is to engage each team member, especially senior leadership, and ensure that everyone is on board to reduce CLABSI occurrences. In a formal, mandatory meeting, I am giving all staff members a detailed overview of the plan as well as an achievable goal for the upcoming fiscal year. While outlining my expectations, I will welcome the infection control team to discuss successful evidence-based strategies and practices.

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