Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days

Beville, Amber Shaye McElveen; Heipel, Diane; Vanhoozer, Ginger; Bailey, Pamela

doi:10.1007/s11908-021-00767-w

Cited by 9 publications

(6 citation statements)

References 38 publications

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“…( 18 ) However, the duration time of the PICC was prolonged to 25.3 days in relation with expected standards (7.3 - 16.6 days). ( 18 )…”

Section: Discussionmentioning

confidence: 59%

“…Limited use of the central venous catheter [CVC] is recommended and in its place use of alternative catheters is recommended, like the MLC or PICC, for use in prolonged treatments. ( 17 , 18 ) Removal of these catheters is recommended upon suspending the treatment for which the catheter was inserted. ( 18 ) This study reported a duration time for the PVC of 3 days (expected standard of 66 h) and time for the MLC of 8 days (expected standard of 7.6 - 16.4 days), which are quite similar to the time ranges observed by other studies.…”

Section: Discussionmentioning

confidence: 99%

“…( 17 , 18 ) Removal of these catheters is recommended upon suspending the treatment for which the catheter was inserted. ( 18 ) This study reported a duration time for the PVC of 3 days (expected standard of 66 h) and time for the MLC of 8 days (expected standard of 7.6 - 16.4 days), which are quite similar to the time ranges observed by other studies. ( 18 ) However, the duration time of the PICC was prolonged to 25.3 days in relation with expected standards (7.3 - 16.6 days).…”

Section: Discussionmentioning

confidence: 99%

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Evaluation of Indicators of a Vascular Access Device Program led by Nursing Professionals in a High-complexity University Hospital in Colombia

Cortés

Parra

Torres

et al. 2022

invest. educ. enferm

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Objective. This work sought to evaluate result indicators of the specialized vascular access program led by nursing during the period between 01 January 2018 and 31 December 2019 at Fundación Cardioinfantil -Instituto de Cardiología (Colombia). Methods. This was a retrospective descriptive study based on medical records of 1,210 patients who received insertion of vascular access devices by the specialized group of nurses. Result indicators are described. Results. Of all the patients who received insertion of a vascular access catheter, 53.1% were women, with mean age of 34.2 years, admitted to critical care services with cardiovascular problems and sepsis (90.2%). Placement of the peripherally inserted central catheter, midline and arterial was echo-guided between 91% and 100%, with a success rate on the first puncture of 66%. The average duration time of the peripherally inserted central catheter was 25.3 days, that of the midline catheter was 8 days, with a reach of 57% until the end of the treatment. The rate observed per catheter-days of overall phlebitis was 2.03, for positive blood culture of the central peripheral insertion device was 1.9 and thrombosis of 0.50; and arterial line thrombosis was 11.7. Conclusion. The Vascular Access Device Program led by nursing reported rational use of these elements with structured therapeutic purposes according with the complexity of the patients admitted to hospitalization. Improvement plans must be implemented to increase efficacy in post-admission insertion times, reduce infection rate and thrombosis through effective follow-up and control mechanisms.

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“…( 18 ) However, the duration time of the PICC was prolonged to 25.3 days in relation with expected standards (7.3 - 16.6 days). ( 18 )…”

Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation of Indicators of a Vascular Access Device Program led by Nursing Professionals in a High-complexity University Hospital in Colombia

Cortés

Parra

Torres

et al. 2022

invest. educ. enferm

View full text Add to dashboard Cite

show abstract

“…6,7,18 Others included leadership daily walkarounds, daily audits, and using EMRs to standardize documentation, with most approaches being multidisciplinary. [19][20][21] Our interventions paralleled much of this work with a strong governance model including leadership commitment, clinician education, peer audits, and updated evidence-based best practices. Our process measures of using CL insertion checklists and use of capped lumens both have shown previous success and good uptake locally.…”

Section: Discussionmentioning

confidence: 98%

A Quality Improvement Initiative to Decrease Central Line–Associated Bloodstream Infections During the COVID-19 Pandemic: A “Zero Harm” Approach

et al. 2023

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Introduction Central line–associated bloodstream infections (CLABSIs) are associated with significant patient harm and health care costs. Central line–associated bloodstream infections are preventable through quality improvement initiatives. The COVID-19 pandemic has caused many challenges to these initiatives. Our community health system in Ontario, Canada, had a baseline rate of 4.62 per 1000 line days during the baseline period. Objectives Our aim was to reduce CLABSIs by 25% by 2023. Methods An interprofessional quality aim committee performed a root cause analysis to identify areas for improvement. Change ideas included improving governance and accountability, education and training, standardizing insertion and maintenance processes, updating equipment, improving data and reporting, and creating a culture of safety. Interventions occurred over 4 Plan-Do-Study-Act cycles. The outcome was CLABSI rate per 1000 central lines: process measures were rate of central line insertion checklists used and central line capped lumens used, and balancing measure was the number of CLABSI readmissions to the critical care unit within 30 days. Results Central line–associated bloodstream infections decreased over 4 Plan-Do-Study-Act cycles from a baseline rate of 4.62 (July 2019–February 2020) to 2.34 (December 2021–May 2022) per 1000 line days (51%). The rate of central line insertion checklists used increased from 22.8% to 56.9%, and central line capped lumens used increased from 72% to 94.3%. Mean CLABSI readmissions within 30 days decreased from 1.49 to 0.1798. Conclusions Our multidisciplinary quality improvement interventions reduced CLABSIs by 51% across a health system during the COVID-19 pandemic.

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“…35 Thereby, both central line insertion and maintenance bundle have to be followed strictly to reduce the CLABSI in intensive care units. 36,37 Active participation of clinicians in the early diagnosis of sepsis and proper collection of samples at an appropriate time for the early diagnosis of sepsis will thereby decrease morbidity and mortality associated with CLABSI. 38,39 More emphasis on teaching and education of medical and paramedical staff regarding the insertion and maintenance bundle for the central line, catheter hub care and after-wound care aids…”

Section: Discussionmentioning

confidence: 99%

Central Line Associated Blood Stream Infection: Microbiological Profile and its Antimicrobial Susceptibility Pattern at Tertiary Care Centre

Darji¹,

Patel²

2023

J. Pure Appl. Microbiol.

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Central venous catheters are commonly inserted to monitor patients with critical illnesses. Even when used to treat very ill patients, they are susceptible to widespread headaches, including central line-associated bloodstream infections (CLABSI). Central line-associated bloodstream infection (CLABSI) is one of the most significant HAIs, associated with excess mortality of 12–25%. To discover CLABSI cases, microbiological profiles, and their antimicrobial susceptibility. The study was conducted in an intensive care unit over a period of 12 months. 150 blood samples and catheter tips were collected for the culture of suspected or secondary bacteremia. CLABSI is described as being consistent with the CDC’s proposal. Automated VITEK 2 technology identifies bacterial isolates and investigates their antimicrobial susceptibility. Out of 150 samples, 50 showed no growth, 45 showed colonizers, 40 showed CLABSI, and 15 showed secondary infection. Fifty-five had positive blood cultures, 15 of whom had another source of infection. In our study, the CLABSI rate was 7.8/1000 central venous days. Rigorous implementation of the system and maintenance of the central line bundle are mandatory to prevent colonization.

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Reducing Central Line Associated Bloodstream Infections (CLABSIs) by Reducing Central Line Days

Cited by 9 publications

References 38 publications

Evaluation of Indicators of a Vascular Access Device Program led by Nursing Professionals in a High-complexity University Hospital in Colombia

Evaluation of Indicators of a Vascular Access Device Program led by Nursing Professionals in a High-complexity University Hospital in Colombia

A Quality Improvement Initiative to Decrease Central Line–Associated Bloodstream Infections During the COVID-19 Pandemic: A “Zero Harm” Approach

Central Line Associated Blood Stream Infection: Microbiological Profile and its Antimicrobial Susceptibility Pattern at Tertiary Care Centre

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