scholarly journals 811. Utilizing IV team in Reducing the Central Line Associated Infections

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S448-S448
Author(s):  
Swetha Srialluri ◽  
Ali Hassoun
Keyword(s):  
Critically Ill ◽  
Financial Burden ◽  
Blood Stream ◽  
Central Line ◽  
Klebsiella Pneumonia ◽  
Blood Stream Infections ◽  
Central Lines ◽  
Increased Risk ◽  
Before And After ◽  
Clabsi Rate

Abstract Background Central Line-Associated Blood Stream Infections (CLABSI) are defined as the laboratory confirmed blood stream infections after 48 hours of the line placement and excluding other sources of infection. CLABSI can lead to prolonged hospital stay, increased risk of mortality and financial burden on the health care system. In our study, we aimed at evaluating the incidence of CLABSI after involving the IV team in both critically ill and non-critically ill patients. Methods A retrospective chart review was performed from July 2011 to August 2019 at a 971 bedded community hospital. IV team has been involved in the central line care since 2013 and started changing the scheduled central line dressings. The interventions that were introduced since then include usage of Curos, wearing masks and gloves for any contact with central lines, flushing the central lines using pulsatile method, and not drawing the routine labs. Allpoints program was introduced in July 2018 which is a retraining program to the nurses emphasizing on central line dressing changes using a sterile technique, pulsatile flushing method and medication administration. CLABSI rate was calculated per 1,000 central line days yearly and quarterly and was compared before and after the involvement of IV team. Results Total number of events from July 2011 to August 2019 were 275. Average central line days were 22,350. Most common organisms that were isolated are Staphylococcus aureus (13.45%) followed by Staphylococcus Epidermidis (9.8%), Candida Albicans (8.7%), E. Coli (8.72%) and Klebsiella Pneumonia (6.9%). The average CLABSI rates quarterly and yearly were 1.00 and 1.32 respectively, per 1000 central line days. Average CLABSI rates before and after the involvement of IV team were 1.32 and 1.18 respectively. CLABSI rate has decreased significantly after the involvement of the IV team in 2013. The largest impact on the CLABSI infection rate was between July 2018 to August 2019 which can be attributed to the Allpoints program. CLABSI rate in 2018 and 2019 were 0.86 and 0.6 respectively. Conclusion Our analysis showed that involving the IV team in the central line care and implementing the preventive strategies like usage of curos, pulsatile flush technique, wearing mask and gloves for any contact with central line helped in reducing CLABSI. Disclosures All Authors: No reported disclosures

Central Line Associated Blood Stream Infections in Pediatric Hematology/Oncology Patients With Different Types of Central Lines

2016 ◽  
Vol 63 (9) ◽  
pp. 1603-1607 ◽  
Author(s):  
Jeffrey D. Hord ◽  
John Lawlor ◽  
Eric Werner ◽  
Amy L. Billett ◽  
David G. Bundy ◽  
...  
Keyword(s):  
Blood Stream ◽  
Central Line ◽  
Oncology Patients ◽  
Blood Stream Infections ◽  
Central Lines ◽  
Pediatric Hematology ◽  
Different Types

The Line Snuggler: A Central Line Bundling Innovation Evaluated in a High-Risk Pediatric Population

2020 ◽  
Vol 38 (1) ◽  
pp. 36-41
Author(s):  
Marybeth Tetlow ◽  
Deborah Allen ◽  
Angel Barnes ◽  
Ryan J. Shaw
Keyword(s):  
Online Survey ◽  
Pediatric Population ◽  
Quality Care ◽  
Blood Stream ◽  
Central Line ◽  
Marrow Transplant ◽  
Post Intervention ◽  
Central Lines ◽  
High Satisfaction ◽  
Increased Risk

Central line associated blood stream infections and complications in children require prevention strategies related to both traditional childhood activities as well as adverse events in the intensive care unit or bone marrow transplant unit. This study evaluated a nurse-invented product, the Line Snuggler, designed to protect intravenous tubing and central lines from contamination or entanglement. Patients ( n = 30) were enrolled following the chemotherapy phase of transplant. Using a pre–post intervention design, each subject served as their own control for the control phase of the study (Days 1-3 without a Line Snuggler) and the intervention phase (Days 4-6 with a Line Snuggler), with bacterial levels of product and sheets tested on Days 1, 3, 4, and 6. At study conclusion, staff ( n = 44) and parents/guardians ( n = 25) completed an online survey assessing satisfaction with the product, and perceived utilization and safety. Using t tests, the Line Snuggler bacterial levels showed no difference in growth in adenosine triphosphate levels compared with the same patient’s sheets, thereby supporting no increased risk of bacterial growth. Both staff and parents/guardians reported high satisfaction with their use of the Line Snuggler and noted the benefit of its protecting and bundling intravenous lines into a single organizer. This innovative product designed by nurses was evaluated as a means to provide exceptional, high-quality care to achieve the best outcomes while eliminating hospital-acquired complications ( https://www.linesnugglers.com/ ).

scholarly journals Is it safe to remove central lines in patients with platelets less than 20,000/uL

2021 ◽  
Author(s):  
Priya Marwah ◽  
Stalin Ramprakash ◽  
Sai Prasad T R ◽  
Mane Gizhlaryan ◽  
Deepa Trivedi ◽  
...  
Keyword(s):  
Platelet Transfusion ◽  
Blood Stream Infection ◽  
Blood Stream ◽  
Central Line ◽  
Severe Thrombocytopenia ◽  
Blood Stream Infections ◽  
Central Lines ◽  
Neutropenic Patients ◽  
Bleeding Episodes ◽  
Clinical Risks

Background: Patients with tunnelled CVL may develop blood stream infections which at times are difficult to control without line removal. Concomitant severe thrombocytopenia with platelet transfusion refractoriness is often considered a hard contraindication to any procedure involving a major blood vessel. There is very little literature on the actual clinical risks of tunnelled central line removal in febrile pancytopenic patients. Procedure: We analysed complications and outcomes in all or patients, a total of 52, who underwent CVL removal with platelets <20,000/uL. Results: No bleeding episodes or unplanned transfusions could be associated with CVL removal. No other complications were also reported. All patients had time to hemostasis within 5 minutes of catheter removal. A total 31 patients were febrile at the time of CVL removal, of which 17 became afebrile within 2 days. We found no difference in response when comparing those whose antibiotic therapy was change/escalation versus those who did not. Removal of CVL under local anaesthesia remained complication-free even at platelets counts less than 20.000/uL. With only RDP support 17 lines were pulled out without any complications when platelets were below 5.000. Conclusion: Our findings suggest that central lines can be safely removed with platelet counts less than 20.000/ul and that this may result in enhanced blood stream infection control. This might be particularly relevant to neutropenic patients in this day and age of MDR germs emergence and paucity of new effective antibiotics.

Use of Antimicrobial Lock Therapy for the Treatment of Central Line-Related Blood-Stream Infections: A Case Series

2018 ◽  
Author(s):  
F. Piersigilli ◽  
C. Auriti ◽  
I. Bersani ◽  
F. Campi ◽  
I. Savarese ◽  
...  
Keyword(s):  
Case Series ◽  
Blood Stream ◽  
Central Line ◽  
Blood Stream Infections ◽  
Lock Therapy

scholarly journals Impact of dexamethasone on the incidence of ventilator-associated pneumonia and blood stream infections in COVID-19 patients requiring invasive mechanical ventilation: a multicenter retrospective study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ines Gragueb-Chatti ◽  
Alexandre Lopez ◽  
Dany Hamidi ◽  
Christophe Guervilly ◽  
Anderson Loundou ◽  
...  
Keyword(s):  
Mechanical Ventilation ◽  
Retrospective Study ◽  
Length Of Stay ◽  
Critically Ill ◽  
Invasive Mechanical Ventilation ◽  
Blood Stream ◽  
Hospital Length Of Stay ◽  
Ventilator Associated Pneumonia ◽  
Blood Stream Infections ◽  
Second Wave

Abstract Background Dexamethasone decreases mortality in patients with severe coronavirus disease 2019 (COVID-19) and has become the standard of care during the second wave of pandemic. Dexamethasone is an immunosuppressive treatment potentially increasing the risk of secondary hospital acquired infections in critically ill patients. We conducted an observational retrospective study in three French intensive care units (ICUs) comparing the first and second waves of pandemic to investigate the role of dexamethasone in the occurrence of ventilator-associated pneumonia (VAP) and blood stream infections (BSI). Patients admitted from March to November 2020 with a documented COVID-19 and requiring mechanical ventilation (MV) for ≥ 48 h were included. The main study outcomes were the incidence of VAP and BSI according to the use of dexamethasone. Secondary outcomes were the ventilator-free days (VFD) at day-28 and day-60, ICU and hospital length of stay and mortality. Results Among the 151 patients included, 84 received dexamethasone, all but one during the second wave. VAP occurred in 63% of patients treated with dexamethasone (DEXA+) and 57% in those not receiving dexamethasone (DEXA−) (p = 0.43). The cumulative incidence of VAP, considering death, duration of MV and late immunosuppression as competing factors was not different between groups (p = 0.59). A multivariate analysis did not identify dexamethasone as an independent risk factor for VAP occurrence. The occurrence of BSI was not different between groups (29 vs. 30%; p = 0.86). DEXA+ patients had more VFD at day-28 (9 (0–21) vs. 0 (0–11) days; p = 0.009) and a reduced ICU length of stay (20 (11–44) vs. 32 (17–46) days; p = 0.01). Mortality did not differ between groups. Conclusions In this cohort of COVID-19 patients requiring invasive MV, dexamethasone was not associated with an increased incidence of VAP or BSI. Dexamethasone might not explain the high rates of VAP and BSI observed in critically ill COVID-19 patients.

Usefulness of procalcitonin in differentiating Candida and bacterial blood stream infections in critically ill septic patients outside the intensive care unit

2017 ◽  
Vol 12 (5) ◽  
pp. 629-635 ◽  
Author(s):  
Filippo Pieralli ◽  
Lorenzo Corbo ◽  
Arianna Torrigiani ◽  
Dario Mannini ◽  
Elisa Antonielli ◽  
...  
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Critically Ill ◽  
Blood Stream ◽  
Blood Stream Infections
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