The Importance Of Bloodstream Infections

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

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.

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.

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.

Central line associated blood stream infection, better known as CLABSI, are on a continual rise in critical patients. CLABSI are implemented to help improve vascular access in patients where venous access is minimal or reduced. They help to maintain intraveneous access to deliver medications to the body and in case of emergency. Central lines are not given to every patient admitted into the hospital, only those who are critical. The purpose of this paper is to provide reasoning and evidence behind my research strategy for this particular topic. In the critical populations, how does not using chlorhexidine containing dressing compare to using the dressings influence the central line associated blood stream infection rates over two years.

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.

Signs of infection of the central venous catheter (CVC) site include redness, drainage, and the client will exhibit chills, fever, and an elevated white blood cell count (Ignatavicious & Workman, 2016). However, it is important to note that the incidence of CLABSIs in United States ICUs have decreased by 58% from 2001 to 2009, saving 3,000 to 6,000 lives as well as $414 million (Dumont & Nesselrodt, 2012). Some hospitals also report to have zero incidences of CLABSIs in their ICUs (Dumont & Nesselrodt, 2012). The pathogen that showed the greatest decrease was staphylococcus aureus (78% decrease), followed by Enterococcus (55% decrease), Candida (46% decrease) and Gram-negative bacteria (37% decrease) (CDC, n.d.).

In the healthcare, evidence-based guidelines are utilized to prevent complications that can be very significant to both the patient and the healthcare in general. Having worked in different health care settings including, home-health, long-term care facilities, rehabilitation hospitals, long-term acute care, and acute care, I have come across various healthcare associated infections (HAIs). For my project, I will focus on prevention of central line-associated bloodstream infections (CLABSIs). I have seen the importance of central lines in management of patient care, be it in nutrition supplementation, hydration, or medication treatments in all the mentioned different settings. I have also encountered infected central lines and the risk they pose to the patients. According to the Centers for Disease Control and Prevention (CDC), CLABSIs result in thousands of deaths each year and billions of dollars in added costs to the U.S. healthcare system, yet these infections are preventable (CDC, 2010).

As common with past iterations, the update makes it possible to develop clinical recommendation practices based on the theoretical rationale, applicability and the effectiveness of the intervention, and scientific data. The recommendations usually range from those being implemented at the time of carrying out a particular treatment procedure on a patient during insertion of the central venous catheter to those related to institutional practices geared towards reducing the CLABSI. Central line infection impacts organizations as well as patients’ cultural background. This health problem has posed a great challenge to individuals and organizations that are forced to spend lots of money in finding proper treatment to those infected. Since central line infection is increasingly becoming common, attention is focused on developing preventive measure to reduce the rate of deaths in patients who develop the infections. Moreover, with the realization that central line infection can be curtailed through evidence-based practices, the prevention of these infections is becoming an attainable goal for many health facilities, health care systems as well as payers. These efforts underscore the need to successfully implement the CLABSI prevention initiatives across the globe through engagement in enlightenment of staff about central line infection and

A Urinary Tract Infection (UTI) is a serious problem in the clinical setting. “UTIs are mostly associated with catheterization” (Hooton, 2010, p. 629). The infection can be described as bacteria invading the urinary tract. More so, the bacteria accounts for nosocomial bacteremia since the patient obtains the infection in the hospital (Hooton et al., 2010). A Catheter Associated Urinary Tract Infection (CAUTI) is common because nurses do not find this problem at the top of their to-do list during their shift. It can be easy for the nurse to become accustomed to a slight deviation from the correct method. Any break in the chain of infection has opened the opportunity for microorganisms to reproduce in a susceptible host. Research has proven that when hospitals, long-term care facilities, and other healthcare settings intervene with making positives changes, less of the patients developed a UTI with catheterization. Infection control with catheterized patients can be implemented and resolved with collaboration and education among healthcare staff.

Central venous catheters, usually called CVCs, are extremely important for patients in any type of intensive care unit. It is because of their crucial role in the care of these patients that their troublesome risk of catheter-related bloodstream infections, sometimes referred to as CR-BSIs, has developed into such a problem. There are approximately 80,000 CR-BSIs diagnosed each year in the United States alone. These infections lead to nearly 28,000 patient deaths in intensive care units. Not only is this a dreadful loss of life; it is also incredibly expensive. Extra care and treatment for a patient suffering from a CR-BSI can cost an average of $45,000. In fact, these infections can cost as much as $2.3 billion for the United States each

Health care-associated infection (HAI), are infections an individual may acquire while they are receiving treatment for another condition within a health care facility. Catheter-associated urinary tract infections (CAUTI) remain the most commonly reported hospital-acquired condition, and the rates continue to rise. Approximately 600,000 patients develop CAUTI each year, leading to increased health care cost, longer hospital stays, and increased morbidity and mortality rates. Furthermore, multiple studies have shown that urinary catheters are placed in patients who do not have an appropriate indication for catheter placement. In order to improve the quality of care and patient safety in our hospitals, CAUTI has become one of the CMS quality

CLABSI is the acronym for central line associated blood stream infection. CLABSI are the third leading cause of hospital acquired infection (HAI). Central line associated infections are life threatening and is a common risk factor associated with central venous catheters (CVC). Peripherally inserted central catheters are a common type of CVC used. Research is conducted to determine whether there is a benefit to reducing CLABSI with use of PICC lines that are coated with antimicrobials. This research compares the impact of chlorhexidine impregnated verses non- chlorhexidine PICC with the risk of CLABSI and VTE development in patients that are immune suppressed, critical care or trauma patients.

As a result of the risk factors that have been associated with this medical procedure, various strategies have been implemented to help reduce if not eliminate the threat of central venous related contagions post insertion. Some of these strategies include the following; disinfection of the needleless connectors, hubs, as well as the injection ports before the use of the central venous catheter (Pongruangporn et al. 2013). Drawing from various research findings on the prevention of CVCs associated infections post insertion, the infection of the center, commonly referred to as the hub of the catheter as a result of the non-sterile access technique has been identified to be the main path for developing infections associated with the insertion of the catheter. Lowering contamination through

It is estimated that 200,000 to 400,000 hospitalized patients with central lines develop bloodstream infections annually in the United States. The prevalence of central line-associated blood stream infections (CLABSIs) have increased, and significantly caused morbidity and mortality in patients. They are a leading cause of preventable health care-associated infections (HAIs) and have resulted in longer hospital stays and higher hospital costs. In order to combat this epidemic, the Centers for Disease Control and Prevention (CDC) aimed at the prevention and reduction of CLABSIs with the development of what is known as the CLABSI Bundle. Efforts by the CDC were paramount in reducing the rate of CLABSI and improving the quality of care