Scatliffe and Davis study
-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.
-All inpatients admitted to any adult unit that had a central line procedure were included in the study. The study defined CLABSI's as recovery of a pathogen from a blood culture in a patient who had a central line at the time of infection or within the 48 hour period before development of infection. The infection could not be related to any other infection the patient might have had and was not present when the patient was admitted to NBIMC. All CLASBI cases were documented.
-The task force consisted of administrators, representatives from Infection Control and Infectious Disease Departments, nurse and physician
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Another research article about the use of 2% chlorhexidine for daily skin cleansing was established by Munoz-Price and implemented by the task force. Munoz-Price demonstrated that this intervention reduces the rate of CLABSI from 9.5 to 3.8 per 1000 catheter days. The task force also replaced the administration sets and add-on devices no more frequently than every 72 hours unless contamination occurred. Replacing tubing used to administer blood, blood products, or lipids within 24 hours of start of infusion was also monitored, along with changing IV port protectors no more often than 72
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
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.
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.
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
CLABSI’s, or Central Line Associated Bloodstream Infections, are a worldwide problem of bloodstream infections from the unsterile insertion or unclean maintenance of a central line catheter, which are inserted in large veins and are in place for weeks or months (CDC, n.d.). CLABSIs have a high morbidity and mortality rate, increases cost of medical treatment and extends the length of hospitalization (Poderman & Girbes, 2002). Implementing evidence based practices have significantly reduced these CLABSI rates (Latif et al., 2015). CLABSI prevention research shows overlap in these five areas of evidence-based prevention: appropriate hand hygiene, skin preparation, use of full barrier preparations, avoidance of femoral site for central line
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
The study determined the most common factors among those sampled to be: an overwhelming majority of male patients (98%), most seeking long-term use for antibiotic treatment (52%) or for venous access (21%), 85% were placed by vascular access nurses within the basilic vein of the right arm (Chopra et al., 2014). Single-lumen PICC devices (48%) were the most commonly used, many placed within medical or surgical units (18%) and remained for a median length of time of 21 days (Chopra et al., 2014). Over a total of 1156 catheter days, 966 PICCs were analyzed, 58 PICCs (6%) acquired CLABSIs. The most common infectious organism was determined to
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
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
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