Scatliffe And Davis Study Summary

Horan, T. C. (2010). Central line-associated bloodstream infection (CLABSI) criteria and case studies. Retrieved from

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.

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

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.

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.

This paper will examine research on multidisciplinary methods used to prevent central line associated blood stream infections (CLABSIs). CLABSIs are a large contributor to increased healthcare costs and increased mortality rates. Research shows how the interventions included in a central line care bundle decrease the risk of CLABSIs. Evidence shows how important it is to target the micro-organisms that pose the biggest threat and how take action against those organisms. Through research a model based off of the Six Sigma Strategies have been shown to be an effective tool in decreasing the occurrence of CLABSIs and decreasing cost for hospitals. There will be discussion of appropriate nursing care that can be implemented into practice to help ward off these life threatening microbes.

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

Berenholtz, S. M., Lubomski, L. H., Weeks, K., Goeschel, C. A., Marsteller, J. A., Pham, J. C., . . . Hines, S. C. (2014). Eliminating central line-associated bloodstream infections: A national patient safety imperative. Infection Control & Hospital Epidemiology, 35(1), 56-62. doi:10.1086/674384

Chlorhexidine has been used for over 60 years for multiple purposes, first being used as a disinfectant in the 1950’s to being introduced in 1988 for the first skin preparation combination launched in the United States and then finally approved by the FDA in 2005 for peri-operative preparation. In 2010 the first chlorhexidine needless connectors were introduced, as well as the first impregnated peripheral inserted central catheter was cleared as an antimicrobial catheter. Over that period it has proven its broad-spectrum efficacy and safety. It has been used in preoperative patient for prevention of nosocomial infections during

4.Introduction Hospital Acquired Infections(HAI) are infections that patients get while receiving treatments for either medical or surgical condition. The common types of HAI in modern health care facilities are; catheter associated urinary track infection, surgical site infection, blood stream infection, pneumonia and, clostridium difficile. Given that HAI’s encompass of vast group of possible sources, this protocol will focus on infections related to surgical site infections involving surgical staff working in the surgical wards. HAI plays an important health impact role in morbidity and mortality in US/Canada. Each year the cost of the Hospital Acquired Infections is rising.

Within the intensive care unit (ICU), one of the most important items or equipment utilized in management of patients is the central venous catheters (CVCs). These are typically devices that can allow intravascular access while terminating at any site close in proximity of the heart or in the neck around the great vessels. CVCs are vital for the management of critically ill and hospitalized patients as they provide or facilitate the procedures such as the medication infusion, blood sampling as well as hemodynamic measurement. Despite their importance, the CVCs are associated with increased cases of central line associated blood-stream infections (CLABSIs) in the healthcare facilities. These CLABSI are among the noted cases of hospital acquired infections for which Medicare cannot reimburse; and apart from the issues of reimbursement, these CLABSI are associated with lengthened hospital stay for patients, increased direct and indirect costs of treatment as well as significant compromise on health and wellness of the patient.

The use of central venous catheters (CVCs) are integral to modern healthcare and have become an increasingly common means of administering treatments that vary from intravenous fluids to blood products to life-saving medications (Sacks et al., 2014; Oto, Imanaka, Konno, Nakataki, & Nishimura, 2011; The Joint Commission, 2012). The use of CVCs allows for immediate vascular access and improved patient comfort as a result of the decreased need for multiple needle sticks. However, their use is associated with an increased risk of blood stream infections. These infections called central-line associated bloodstream infections (CLABSIs) cause significant morbidity, mortality, and increased health care costs (Ramirez, Lee, & Welch, 2012; Sacks et al., 2014; Sandora et al., 2014 Wright et al., 2013; The Joint Commission, 2012).

Great job you nurses are doing at your unity. Central line associated blood stream infection (CLABSI) is one of the major problems most hospitals are experiencing. As explained by Boubekri, (2013) health care associated infections are a measure problem in most hospital and about 70% are from centrals lines. An effort put in place at my hospital was the use of chlorhexidine (CHG) wipes, we use them daily with patients that have a central line, wiping the daily around the central line side to reduce infection. Boubekri went further to explain in the article that the use of CHG wipe daily reduce the CLABSI. We use the CHG wipes on patients going for surgery, patients on Foley catheter, and any invasive procedure. It has really helped to reduce

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

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