Central Lines Infection Paper

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.

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.

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

-A task force was created to address the increase number of central line associated bloodstream infections at Newark Beth Israel Medical Center from 1/12 to 12/12. However the study ended 12/13 as a control of the task forces implemented strategies. There were 68 adult patients which had a rate of about 14.7 per 1000 central line days in an adult inpatient patient. Most infections were in the ICU.

Before bathing/showering with soap and water prior to a procedure/surgery was accepted. It has been proven that antiseptic showering decreases skin microorganism count. Chlorhexidine gluconate products necessitate the need for several applications for the maximum antimicrobial benefit. Thus, each patient receives two preoperative antiseptic showers.

Central lines are a common device used world wide in acute care settings for eligible patient populations such as those receiving chemotherapy, patients with poor venous access, or for those that require prolonged treatment of intravenous medications. Although central lines provide many advantages, they place patients at high risk for acquiring central line associated blood stream infections (CLABSI). CLABSI's are a serious complication associated with central lines and in some cases can be life threatening. There are many evidence based approaches that are used in acute care settings to reduce the incidence of CLABSI's such as meticulous skin care, daily bathing with chlorehexadine surgical scrub, and strict sterile technique when changing central line dressings. These prevention measures are a standard of care nationwide for patients with central lines since they are cost effective and evidence based. Unfortunately, even with proper implementation and compliance with these interventions, CLABSI's are still prevalent amongst vulnerable patient populations.

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 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 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

Hospital acquired infections (HAI) are inflecting a tremendous impact on healthcare safety and medical costs. The purpose of this qualitative analysis is to evaluate current research and evidence based practice on central line acquired blood stream infections (CLABSI) in the neonatal intensive care unit (NICU). Further, this paper will examine how the closed medication line system can help decrease of a CLABSI event. Neonates are a vulnerable population with a low immune suppression where an infection could simply mean life or death. This particular topic is crucial; with the continual rise in pre-term neonates, this topic is crucial to eliminate CLABSI 100% in the NICU environment

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

According to CDC, each year estimated about 250,000 cases of central line-associated bloodstream infection on happens in United States. The average cost of treatment of this CLABSIs are 25,000 dollar per episode. CLABSI is the third most common health care associated infections per Health and Human Service. And also there is reported about 500 to 4000 patients death related to CLABSI in US. CLABSI are preventable but there are need to be much education and resources needed. The central line associated infections are classified as exit site infection or tunnel infection. Nurses are the key health care personnel work with Central lines at the bedside. Nurses play a key role in assessment and prevention and management of these lines to avoid infection. Nurses working with lines must be educated on the importance of infection prevention and held to a high standard on infection control.

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

Blood-stream infections affect more than 700,000 in the U.S. resulting in a healthcare cost of $20 billion annually. The current standard is to administer multiple general antibiotics first, followed by a blood culture to identify the infecting bacteria. This method takes days and puts the patient at risk because these general antibiotics are not often effective due to the rise of antibiotic-resistant bacteria. Doctors overmedicate hospital patients due to the wait time for infection analysis. This excessive medication has led to the deaths of patients. Instead of doing lab analysis, the rapid diagnostic device receive the blood sample, analyze whether the type of infection, and report the effective medications. This would prevent the prescription

When people go into hospitals, they expect to be treated from what illness they have. The US Center for Disease Control and Prevention states that one in twenty-five patients will obtain nosocomial infections (Mercola No p). Readers may think that these statistics are not that bad, but when readers become educated on how dangerous and how easy it is to acquire this infection they will think twice. The most common ways to acquire nosocomial infections are central line-associated bloodstream, catheter-associated urinary tract, surgical site after surgery, clostridium difficile infections (Mercola No. p). People may think to take antibiotics to help get over illness. In the long run taking antibiotics is not always going to help a person. Some pathogens that antibiotics are resistant to are Carbapenem-resistant Enterobacteriaceae (CRE), Neisseria Gonorrhoeae,