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Common themes that have come up during COVID CLABSI case reviews and/or during the ICU central line prevalence day: ❖ Overdue transparent dressings ❖ Overdue cap changes ❖ Overdue and not labeled tubing ❖ Curos caps missing ❖ Daily CHG treatment not documented at least once every 24 hours New Considerations in COVID Care Line Selection: ❖ Consider a more permanent line (PICC) for patients with an expected longer length of stay ❖ Consult R-VAT team: Pager VEIN (8346) or PICC (7422)

Background Fecal contamination is a major challenge in patients in acute/critical care settings that is associated with increased cost of care and supplies and with development of pressure ulcers, incontinence dermatitis, skin and soft tissue infections, and urinary tract infections. Objectives To assess the economic impact of fecal containment in bedridden patients using 2 different indwelling bowel catheters and to compare infection rates between groups. Methods A multicenter, observational study was done at 12 US sites (7 that use catheter A, 5 that use catheter B). Patients were followed from insertion of an indwelling bowel catheter system until the patient left the acute/critical care unit or until 29 days after enrollment, which ever came first. Demographic data, frequency of bedding/dressing changes, incidence of infection, and Braden scores (risk of pressure ulcers) were recorded. Results The study included 146 bedridden patients (76 with catheter A, 70 with catheter B) who had similar Braden scores at enrollment. The rate of bedding/dressing changes per day differed significantly between groups (1.20 for catheter A vs 1.71 for catheter B; P = .004). According to a formula that accounted for personnel resources and laundry cycle costs, catheter A cost $13.94 less per patient per day to use than did catheter B. Catheter A was less likely than was catheter B to be removed during the observational period (P = .03). Observed infection rates were low. Conclusion Catheter A may be more cost-effective than catheter B because it requires fewer unscheduled linen changes per patient day. C E 1.5 Hours Notice to CE enrollees:A closed-book, multiple-choice examination following this article tests your under standing of the following objectives:1. Understand the economic impact of 2 commercial bowel catheter systems.2. Determine if it is possible to state with statistical significance that the 2 commercial bowel catheter systems affect the incidence of skin/soft tissue and urinary tract infections.3. Recognize if the 2 commercial bowel catheter systems affect pressure ulcer risk.

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