Central Venous Catheter Securement: Using the Healthcare and Technology Synergy Model to Take a Closer Look

Abstract Proper securement provides a safe vascular access device environment for both patients and health care providers. Successful securement protects central venous catheters from several sources of failure until the end of therapy by preventing central venous catheter movement during all phases of care. Movement causes vein trauma, bacterial migration, distal tip location variation, loss of dressing integrity, and even total dislodgement. Any of these events can have serious consequences, including catheter-related bloodstream infection, thrombosis, delay of treatment, catheter replacement, and potential hemorrhage, all of which can be life-threatening events, and increase costs. We review patient issues, practice issues, and the types of securement currently used in clinical settings.

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Relation between Health Care Providers´ Compliance with Central Venous Catheter Care Bundle Elements and The Length of Stay in Cardiac Care Units, National Heart Institute.

The Egyptian Journal of Community Medicine ◽

10.21608/ejcm.2018.23000 ◽

2018 ◽

Vol 36 (4) ◽

pp. 87-93

Keyword(s):

Health Care ◽

Length Of Stay ◽

Central Venous Catheter ◽

Health Care Providers ◽

Venous Catheter ◽

Care Bundle ◽

Cardiac Care ◽

Care Providers ◽

Central Venous ◽

Heart Institute

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Management and Prevention of Central Venous Catheter-Related Infections in the ICU

Seminars in Respiratory and Critical Care Medicine ◽

10.1055/s-0039-1693705 ◽

2019 ◽

Vol 40 (04) ◽

pp. 508-523 ◽

Cited By ~ 5

Author(s):

Niccolò Buetti ◽

Jean-François Timsit

Keyword(s):

Risk Factors ◽

Central Venous Catheter ◽

Health Care Providers ◽

Venous Catheter ◽

Audit And Feedback ◽

Catheter Removal ◽

Care Providers ◽

Central Venous ◽

Improvement Program ◽

Frequent Event

AbstractCentral venous catheter-related bloodstream infections (CR-BSI) are a frequent event in the intensive care unit (ICU) setting. In contrast to other nosocomial infections, most risk factors for CR-BSI are linked to the device and can be prevented efficiently. Rates of CR-BSI higher than 1 per 1,000 catheter days are no longer acceptable. A continuous quality improvement program is effective to reduce them. Key elements of prevention of CR-BSI are hand hygiene, avoidance of insertion of unnecessary catheters, full sterile barrier precautions at insertion, preferential use of subclavian venous insertion site, cutaneous antisepsis with 2% chlorhexidine alcoholic preparation, use of chlorhexidine-impregnated dressings, immediate replacement of moistened or detached catheter dressings, and removal of catheters as soon as possible. Audit and feedback of the process of care, infection rates, and periodic re-education of health care providers are other instrumental tools in the prevention of CR-BSI. Catheter removal is the main therapeutic intervention, especially recommended in the case of sepsis or shock. While awaiting culture results, an empiric antimicrobial treatment of CR-BSI should target gram-positive microorganism (i.e., Staphylococcus aureus) and gram-negative coverage should be based on clinical variables, patients' risk factors, and previous colonization status. While a short course of antimicrobials (7 days) is sufficient for noncomplicated CR-BSI, a longer course of 14 days should be preferred for uncomplicated S. aureus and Candida CR-BSI. In case of persisting fever or positive blood culture after 3 days despite adequate antimicrobial therapy and catheter removal, catheter-related complications (e.g., endocarditis, thrombophlebitis, septic metastasis) should be ruled out.

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Awareness of ventilator and central venous catheter bundles among critical care providers in Nigeria

Connect The World of Critical Care Nursing ◽

10.1891/1748-6254.11.3.55 ◽

2017 ◽

Vol 11 (3) ◽

pp. 55-58

Author(s):

Abdullahi S Ibrahim ◽

Halima S Kabara ◽

Adebayo Adeyinka ◽

Louisdon Pierre

Keyword(s):

Critical Care ◽

Central Venous Catheter ◽

Venous Catheter ◽

Care Providers ◽

Central Venous

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Life-Threatening Mediastinal Hematoma Caused by Extravascular Infusion Through a Triple-Lumen Central Venous Catheter

Anesthesia & Analgesia ◽

10.1213/01.ane.0000117148.40842.ca ◽

2004 ◽

Vol 99 (1) ◽

pp. 31-35 ◽

Cited By ~ 11

Author(s):

Matthias Hohlrieder ◽

Rosmarie Oberhammer ◽

Ingo H. Lorenz ◽

Josef Margreiter ◽

Gabriele Kühbacher ◽

...

Keyword(s):

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous ◽

Mediastinal Hematoma ◽

Life Threatening

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Simultaneous Catheter Replacement for Infectious and Mechanical Complications without Interruption of Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.3747/pdi.2014.00313 ◽

2016 ◽

Vol 36 (2) ◽

pp. 182-187 ◽

Cited By ~ 9

Author(s):

John H. Crabtree ◽

Rukhsana A. Siddiqi

Keyword(s):

Peritoneal Dialysis ◽

Central Venous Catheter ◽

Venous Catheter ◽

Central Venous ◽

Technique Survival ◽

Mechanical Complications ◽

Tunnel Infection ◽

Catheter Complications ◽

Systemic Antibiotics ◽

Catheter Replacement

BackgroundConventional management for peritoneal dialysis (PD)-related infectious and mechanical complications that fails treatment includes catheter removal and hemodialysis (HD) via a central venous catheter with the end result that the majority of patients will not return to PD. Simultaneous catheter replacement (SCR) can retain patients on PD by avoiding the scenario of staged removal and reinsertion of catheters. The aim of this study was to evaluate a protocol for SCR without interruption of PD.MethodsClinical outcomes were analyzed for 55 consecutive SCRs performed from 2002 through 2012 and followed through 2013.ResultsSimultaneous catheter replacements were performed for 28 cases of relapsing peritonitis, 12 cases of tunnel infection, and 15 cases of mechanical catheter complications. All cases for peritonitis and tunnel infection and 80% for mechanical complications continued PD on the day of surgery using a low-volume, intermittent automated PD protocol. Systemic antibiotics were continued for 2 weeks postoperatively (up to 4 weeks for Pseudomonas). Simultaneous catheter replacement was performed as an outpatient procedure in 89.1% of cases. Only 1 of 55 procedures was complicated by peritonitis within 8 weeks. No catheter losses occurred during this postoperative timeframe. Long-term, SCR enabled a median technique survival of 5.1 years.ConclusionsIn most instances, SCR can be safely performed without interruption of PD for selected cases of peritonitis and tunnel infection and for mechanical catheter complications. The procedure spares the patient from a central venous catheter, a shift to HD, the psychological ordeal of a change in dialysis modality, and a second surgery to insert a new catheter.

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