Reducing Central Line Infections?

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

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.

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

A two-year program called On the CUSP: Stop BSI was formulated in 2008 to prevent CLABSIs in hospitals nationwide and was organized as a state or region-level collaborative with centralized education, data collection, and program management functions (AHRQ, 2012). More than 1,000 hospitals and 1,800 hospital units, representing a total of 44 states, the District of Columbia, and Puerto Rico, participated in the program (AHRQ, 2012). The program structure included three main components: (1) a model to translate evidence into practice at the bedside to prevent CLABSIs; (2) the CUSP to improve the safety culture; and (3) a system to measure and report infection data (Sawyer et al., 2010). Results of the program revealed success in reducing CLABSIs nationwide by 41% from a baseline of 1.915 infections per 1,000 line days to a rate of 1.133 infections (AHRQ, 2012). With the nationwide success of the On the CUSP: Stop BSI program (AHRQ, 2012), the state of Hawaii embarked on their own study to determine if a national ICU collaborative to reduce CLABSIs would succeed in the state (Lin et al., 2012). The study, which began in January 2009 and ended in December 2010, included the CUSP, a multifaceted intervention approach to CLABSI prevention, and infection rate monitoring (Lin et al., 2012). Data was collected and reported from 20 ICUs representing 16 hospitals across the state (Lin et al., 2012). The results revealed the overall mean 9statewide CLABSI rates decreased 61% from 1.5 infections per 1,000 catheter days at baseline to 0.6 at 16 to 18 months post-implementation of the project, reinforcing the evidence that the On the CUSP: Stop BSI program can succeed in other states and substantially reduce CLABSI rates in hospitals (Lin et al., 2012). The success of the initial Hawaii study was the catalyst to conduct a second study in the state. This cohort study continued the national On the CUSP: Stop BSI program interventions, extended

Elimination of HAI’s are a top priority for many healthcare related organizations and as such, the reduction of certain types of HAIs have been achieved. On the national level, the HAI Progress Report states that there has been, “Au 46 percent decrease in central line-associated bloodstream infections (CLABSI) and a 19 percent decrease in select surgical site infections (SSIs) between 2008 and 2013” as well as “an 8 percent decrease in hospital-onset MRSA bacteremia and a 10 percent decrease in hospital-onset C. difficile infections between 2011 and 2013” (CDC, 2015).

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.

Peripherally inserted central catheters (PICCs) can be used for routine patient care for treatment and have been increasingly used over the past years. They are more invasive than a peripheral intravenous line (PIV); however, they can be inserted at the bedside, are easily removed, and provide many positive benefits. PICCs relieve patients from frequent venipuncture for serial lab draws, decreases frequent re-starts of PIVs, and the patient can be discharged home, if needed, for continued IV therapy. Although there are benefits to these easily inserted central lines, central line-associated bloodstream infections (CLABSI) are a possibility (Dumont & Nessselrodt, 2012).

There is an abundance of information identifying central line acquired bloodstream infection (CLABSI) as a serious adverse event during hospitalization resulting in increased morbidity, mortality, and health care cost. Present data from research indicates that CLABSI is the second most avoidable cause of death during hospitalization (Shah, Schwartz, & Cullen, 2016). The above concepts that CLABSI is preventable yet it continues to yield a yearly cost of 2.3 billion dollars and remains a quality metric for national offices such as Joint Commission indicates a foundation for research (Son et al., 2012). Upon the literature review, CLABSI rates were significantly reduced when specific techniques were implemented. Furthermore, all the articles

After microorganisms enter the patient’s body they can go to the lungs and cause pneumonia. Central line-bloodstream infections occur when microorganism enter the bloodstream by the intravenous line. Microorganisms are transfer into the blood stream by inadequate hand hygiene or improper intravenous fluid, tubing, and site care practice. Multidrug-resistant organisms can cause infections of the blood, skin, or organ systems. These infections can arise due to the overuse or misuse of antibiotics, which can result in the microorganisms becoming more resistant to antibiotic therapy. Methicillin-resistant Staphyloccocus aureus and Clostridium difficile are examples of this kind of infection. Health care employees need to know the different types of hospital acquired infections and how they are spread to be able to effectively prevent them.

Central Lines are inserted for a number of clinical reasons including measurement of CVP, Administration of IV drugs, IV fluids, Blood Draw for difficult to stick patients and some times for nutritional reason (Administration of TPN). The main benefit of central line is for extremely sick people multiple drugs/treatments can be administered simultaneously. The major disadvantages of central lines, it can increase the risk of infection, pneumothorax, hemothorax, subclavian artery puncture, Catheter misplacement, air embolism, thrombosis and malfunctioning. The aim of this study is to discuss the methods adopted by hospitals to minimize

Nurses should also have patients demonstrate hand washing technique. Teaching patients about infusion therapy and how to avoid the risk of intravenous infection will help calm their fears and decrease their risks of obtaining an infection. Technology today can help by having patients either record a video of the steps on their smart phone or by writing the steps down. This can decrease patient’s anxiety and stress while increasing confidence. While this topic has been around for many years, both medical professionals and patients need to be educated and strict compliance needs to be followed in order to avoid intravenous and central line infections. Further research is needed in order to discover additional ways of decreasing intravenous and central line infections in the home