Prevention of central venous catheter–associated bloodstream infections: A questionnaire evaluating the knowledge of the selected 11 evidence-based guidelines by Polish nurses

Objective.The goal of this effort was to reduce central venous catheter (CVC)-associated bloodstream infections (BSIs) in pediatric intensive care unit (ICU) patients by means of a multicenter evidence-based intervention.Methods.An observational study was conducted in 26 freestanding children's hospitals with pediatric or cardiac ICUs that joined a Child Health Corporation of America collaborative. CVC-associated BSI protocols were implemented using a collaborative process that included catheter insertion and maintenance bundles, daily review of CVC necessity, and daily goals. The primary goal was either a 50% reduction in the CVC-associated BSI rate or a rate of 1.5 CVC-associated BSIs per 1,000 CVC-days in each ICU at the end of a 9-month improvement period. A 12-month sustain period followed the initial improvement period, with the primary goal of maintaining the improvements achieved.Results.The collaborative median CVC-associated BSI rate decreased from 6.3 CVC-associated BSIs per 1,000 CVC-days at the start of the collaborative to 4.3 CVC-associated BSIs per 1,000 CVC-days at the end of the collaborative. Sixty-five percent of all participants documented a decrease in their CVC-associated BSI rate. Sixty-nine CVC-associated BSIs were prevented across all teams, with an estimated cost avoidance of $2.9 million. Hospitals were able to sustain their improvements during a 12-month sustain period and prevent another 198 infections.Conclusions.We conclude that our collaborative quality improvement project demonstrated that significant reduction in CVC-associated BSI rates and related costs can be realized by means of evidence-based prevention interventions, enhanced communication among caregivers, standardization of CVC insertion and maintenance processes, enhanced measurement, and empowerment of team members to enforce adherence to best practices.

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The Role of Biofilm in Central Venous Catheter Related Bloodstream Infections: Evidence-based Nursing and Review of the Literature

Reviews on Recent Clinical Trials ◽

10.2174/1574887114666191018144739 ◽

2020 ◽

Vol 15 (1) ◽

pp. 22-27 ◽

Cited By ~ 3

Author(s):

Nicola Ielapi ◽

Emanuela Nicoletti ◽

Carmela Lorè ◽

Giorgio Guasticchi ◽

Tiziana Avenoso ◽

...

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Infectious Complications ◽

Evidence Based ◽

Central Venous ◽

Device Management ◽

Bibliographic Search ◽

Materials Used ◽

Evidence Based Nursing

Background: Biofilm is a fundamental component in the pathogenesis of infections related to the use of the central venous catheter (CVC,) which can represent an important health issue in everyday practice of nursing and medical staff. Objective: The objective of the following review is to analyze the components of biofilm and their role in catheter-related infection determinism in an evidencebased nursing perspective in such a way as to give health professionals useful suggestions in the prevention and management of these complications. Methods: The following databases were consulted for the bibliographic search: Medline, Scopus, Science Direct. Biofilm can be the cause of CVC extraction and can lead to serious haematogenic infectious complications that can increase the morbidity and mortality of affected patients. Results: Updated pathophysiologic knowledge of biofilm formation and appropriate diagnostic methodology are pivotal in understanding and detecting CVC-related infections. Lock therapy appears to be a useful, preventive, and therapeutic aid in the management of CVCrelated infections. New therapies attempting to stop bacterial adhesion on the materials used could represent new frontiers for the prevention of CVC-related infections. Conclusion: The correct evidence-based nursing methods, based on the use of guidelines, provides the opportunity to minimize the risks of infection through the implementation of a series of preventive measures both during the CVC positioning phase and in the subsequent phase, for example, during device management which is performed by medical and nursing staff.

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Complications Associated With Use of Long-Term Central Venous Catheters Among Commercially Insured Women With Breast Cancer

Journal of Oncology Practice ◽

10.1200/jop.2015.004796 ◽

2015 ◽

Vol 11 (6) ◽

pp. 505-510 ◽

Cited By ~ 3

Author(s):

Allison Lipitz-Snyderman ◽

Qinli Ma ◽

Michael F. Pollack ◽

John Barron ◽

Elena B. Elkin ◽

...

Keyword(s):

Breast Cancer ◽

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous Catheters ◽

Evidence Based ◽

Central Venous ◽

Evidence Based Guidelines

Long-term central venous catheter (CVC) use is associated with increased morbidity. Evidence-based guidelines tools may help decrease discretionary use of long-term CVCs resulting from provider- or institution-driven variations in practice.

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Preventing Catheter-Associated Bloodstream Infections: A Survey of Policies for Insertion and Care of Central Venous Catheters From Hospitals in the Prevention Epicenter Program

Infection Control and Hospital Epidemiology ◽

10.1086/499151 ◽

2006 ◽

Vol 27 (1) ◽

pp. 8-13 ◽

Cited By ~ 42

Author(s):

David K. Warren ◽

Deborah S. Yokoe ◽

Michael W. Climo ◽

Loreen A. Herwaldt ◽

Gary A. Noskin ◽

...

Keyword(s):

Hand Hygiene ◽

Nurse Managers ◽

Tertiary Care ◽

Bloodstream Infections ◽

Venous Catheter ◽

The United States ◽

Evidence Based ◽

Central Venous ◽

Single Location ◽

Evidence Based Guidelines

Objective.To determine the extent to which evidence-based practices for the prevention of central venous catheter (CVC)-associated bloodstream infections are incorporated into the policies and practices of academic intensive care units (ICUs) in the United States and to determine variations in the policies on CVC insertion, use, and care.Design.A 9-page written survey of practices and policies for nontunneled CVC insertion and care.Setting.ICUs in 10 academic tertiary-care hospitals.Participants.ICU medical directors and nurse managers.Results.Twenty-five ICUs were surveyed (1-6 ICUs per hospital). In 80% of the units, 5 separate groups of clinicians inserted 24%-50% of all nontunneled CVCs. In 56% of the units, placement of more than two-thirds of nontunneled CVCs was performed in a single location in the hospital. Twenty units (80%) had written policies for CVC insertion. Twenty-eight percent of units had a policy requiring maximal sterile-barrier precautions when CVCs were placed, and 52% of the units had formal educational programs with regard to CVC insertion. Eighty percent of the units had a policy requiring staff to perform hand hygiene before inserting CVCs, but only 36% and 60% of the units required hand hygiene before accessing a CVC and treating the exit site, respectively.Conclusion.ICU policy regarding the insertion and care of CVCs varies considerably from hospital to hospital. ICUs may be able to improve patient outcome if evidence-based guidelines for CVC insertion and care are implemented.

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Central venous catheter bundle implementation in an intensive care unit in Kuwait: Effect on central line-associated bloodstream infections

10.26226/morressier.56d5ba30d462b80296c95453 ◽

2016 ◽

Author(s):

Mona Salama

Keyword(s):

Intensive Care Unit ◽

Intensive Care ◽

Central Venous Catheter ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Line ◽

Central Venous

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Costs and prolonged length of stay of central venous catheter-associated bloodstream infections (CVC BSI): a matched prospective cohort study

Infection ◽

10.1007/s15010-013-0494-z ◽

2013 ◽

Vol 42 (1) ◽

pp. 31-36 ◽

Cited By ~ 25

Author(s):

R. Leistner ◽

E. Hirsemann ◽

A. Bloch ◽

P. Gastmeier ◽

C. Geffers

Keyword(s):

Cohort Study ◽

Length Of Stay ◽

Central Venous Catheter ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Bloodstream Infections ◽

Venous Catheter ◽

Central Venous ◽

Prolonged Length

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Bedside ultrasound as a screening test for the diagnosis of catheter-related bloodstream infection (CRBI)

Journal of Ultrasound ◽

10.1007/s40477-020-00538-8 ◽

2021 ◽

Author(s):

Chiara de Sio ◽

Mario Venafro ◽

Giampiero Foccillo ◽

Riccardo Nevola ◽

Lucio Monaco

Keyword(s):

Central Venous Catheter ◽

Bloodstream Infections ◽

Signs And Symptoms ◽

Venous Catheter ◽

Central Catheter ◽

Central Venous ◽

Roc Curve Analysis ◽

Suspected Infection ◽

Intravascular Devices ◽

A Prospective Study

Abstract Purpose Between 15 and 30% of all nosocomial bacteremias and sepsis are associated with the use of intravascular devices. Catheter-related bloodstream infections (CRBI) are infections in which the organism identified in the blood is also present on the tip of the catheter itself or in a blood sample taken through it. The aim of the study was to evaluate the role of ultrasound in the diagnosis of infections related to the use of central catheters. Methods Between January 2018 and June 2019, we carried out a prospective study on 36 patients with a central catheter, such as a central venous catheter (CVC), a central catheter with peripheral insertion (PICC), or a fully implanted central venous catheter (PORT-a-cath) and who had signs and symptoms of infection. These patients were submitted to an ultrasound of the catheter upon arrival in the ward in case of suspected infection, or at the time of the onset of signs and symptoms of infection (if these arose during hospitalization). Patients with a central catheter but without signs and symptoms of infection were not included in the study. The end point of the study was to evaluate sensitivity (SENS), specificity (SPEC), positive and negative predictive value (PPV-NPV) and overall diagnostic accuracy (ODA) of ultrasound in the diagnosis of CRBI through Receiver Operating Characteristic (ROC) curve analysis. Results US showed a SENS of 94%, a SPEC of 84%, a PPV of 84%, an NPV of 94% and an ODA of 88.8% for the diagnosis of CRBI. Conclusions Preliminary data from our study show that US of intravascular devices has a high SENS and SPEC in the diagnosis of CRBI, and can, therefore, be used as a valid tool to decide whether to remove the device early or leave it in place.

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