Central venous catheter-related bloodstream infections: improving post-insertion catheter care

2009 ◽  
Vol 71 (2) ◽  
pp. 117-122 ◽  
Author(s):  
I.M. Shapey ◽  
M.A. Foster ◽  
T. Whitehouse ◽  
P. Jumaa ◽  
J.F. Bion
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous ◽  
Catheter Care

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

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.

Microbiological screening for earlier detection of central venous catheter-related bloodstream infections

2013 ◽  
Vol 43 (9) ◽  
pp. 964-969 ◽  
Author(s):  
Jasmin Wagner ◽  
Gernot Schilcher ◽  
Ines Zollner-Schwetz ◽  
Martin Hoenigl ◽  
Thomas Valentin ◽  
...  
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Venous Catheter ◽  
Central Venous

scholarly journals Effect of Central Venous Catheter Care Bundle Implementation on Outcomes of Critically Ill Patients

2020 ◽  
Vol 2 (1) ◽  
pp. 12
Author(s):  
Gehan A. F. Atia
Keyword(s):  
Central Venous Catheter ◽  
Bloodstream Infection ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Catheter ◽  
Care Bundle ◽  
Central Venous ◽  
Significant Difference ◽  
Post Test ◽  
Catheter Care

Context: Central venous access device (CVAD) bundles for insertion and maintenance demonstrate a reduction in the frequency of complications and bloodstream infection when implemented with compliance monitoring, with the reported success of CVAD bundles. Aim: This study aimed to examine the effect of central venous catheter care bundle implementation on outcomes of critically ill patients. Methods: Quasi-experimental research (pre/post-test design) used to achieve the aim of this study. The study conducted at general and surgical intensive care units affiliated to Menoufia University and teaching hospital. Two study samples recruited in this study. All nurses working at the ICUs, as mentioned above, were recruited in this study. They were 6o critical care nurses. A convenient sample of all available critically ill patients at the time of the study was subjected to treatment via a central venous catheter. Four study tools used to collect the data of this study. These are a structured interview questionnaire, CVC nurses’ knowledge assessment questionnaire, nurses’ compliance assessment checklists, and patient complications assessment records. Results: The study result showed a highly statistically significant difference between pre and post-test knowledge scores of studied nurses regarding assisting line insertion, removal, maintenance, care, and infection control practices. Besides, a highly statistically significant difference between pre and post-test scores of nurses’ compliance to central venous catheter care practices of assisting in CVC insertion, blood sample withdrawal, medication and fluid administration, CVP measurements, CVC removal, and the management of central venous line complications. The study also revealed a highly statistically significant difference between the study and control group patients regarding the central venous catheter complications. However, signs of infection were the most frequent complications in both groups. Conclusion. The study concluded that a statistically significant difference between pre and post nurses’ knowledge and compliance with the CVC care bundle. The patients’ outcomes were also improved significantly after the implementation of the CVC care bundle compared to the controls. The study recommended the adoption of the current care bundle that should be disseminated and updated following the international organizations’ recommendation for implementing evidence-based practices for successful central line-associated bloodstream infection (CLABSI) prevention.

scholarly journals Bundle Approach to Reduce Bloodstream Infections in Neutropenic Hematologic

2015 ◽  
Vol 28 (4) ◽  
pp. 474
Author(s):  
Jose Manuel Martinez ◽  
Luís Leite ◽  
Daniela França ◽  
Rita Capela ◽  
Luísa Viterbo ◽  
...  
Keyword(s):  
Relative Risk ◽  
Central Venous Catheter ◽  
Bloodstream Infections ◽  
Mechanical Valve ◽  
Venous Catheter ◽  
Positive Pressure ◽  
Control Group ◽  
Study Group ◽  
Central Venous

<p><strong>Introduction:</strong> The objective of the study was to reduce, by a bundle of interventions, the global bloodstream infections and catheterrelated bloodstream infections rates in neutropenic hematology patients with a long-term central venous catheter.<br /><strong>Material and Methods:</strong> This was a non-randomized prospective study. It was conducted in a 20-bed hematology oncology unit (Portuguese Institute of Oncology, Porto, Portugal) between 1st of August 2010 and 31st of January 2012. In this period we introduced a bundle of interventions (study group) and compared the results with the six months prior to implementation (control group). The interventions consisted in the use of a neutral pressure mechanical valve connector instead of a positive pressure mechanical valve connector, a more frequent change of this connector and a more efficient clean solution. One hundred and sixteen hematology patients with a long-term central venous catheter at time superior of 72 h, with 8 867 central venous catheter days [6 756 central venous catheter days in the study group and 2 111 central venous catheter days in the control group] were included in the study.<br /><strong>Results:</strong> A significant reduction in bloodstream infections rates and catheter-related bloodstream infections rates was achieved. Bloodstream infections rates: [32.69 (control group) vs. 9.43 (study group)], incidence reduction 71% [relative risk 0.2886, CI 95% (0.1793 – 0.4647), p &lt; 0.001] and catheter-related bloodstream infections rates: [17.53 (control group) vs. 4.73 (study group)], incidence reduction 71% [relative risk 0.2936, CI 95% (0.1793 – 0.5615), p &lt; 0.014]. No significant difference (p &gt; 0.05) was found in the neutrophil count at the time of blood culture samples between groups: 69% (&lt; 500 neutrophils/mm3) [71% (study group) vs. 68% (control group)].<br /><strong>Conclusions:</strong> The introduction of this bundle of interventions based on the variables of patient, product and practice, supported by the Healthcare and Technology Synergy framework, quickly resulted in a significant reduction of bloodstream infections and catheterrelated bloodstream infections rates.</p>

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