A Simple Educational Intervention to Decrease Incidence of Central Line–Associated Bloodstream Infection (CLABSI) in Intensive Care Units with Low Baseline Incidence of CLABSI

Parra, Alfonso Pérez; Menárguez, María Cruz; Granda, María Jesús Pérez; Tomey, M.J.; Padilla, Belén; Bouza, Emilio

doi:10.1086/655841

Cited by 40 publications

(38 citation statements)

References 12 publications

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“…Multiple studies have shown that most, if not all, CLABSIs are preventable, and extensive guidelines have been developed in order to guide best practice for CVC placement (14). Successful strategies to reduce CLABSIs include the implementation of educational programs directed to the entire multidisciplinary ICU team (15)(16)(17)(18). These programs typically stress adherence to best practice behaviors known to prevent CLABSIs, including the use of full barrier precautions (19), skin prep at the insertion site (20), appropriate hand hygiene (21,22), and specifying the anatomic site of CVC placement (subclavian preferred to internal jugular preferred to femoral) (23)(24).…”

mentioning

confidence: 99%

Effectiveness of Minocycline and Rifampin vs Chlorhexidine and Silver Sulfadiazine-Impregnated Central Venous Catheters in Preventing Central Line-Associated Bloodstream Infection in a High-Volume Academic Intensive Care Unit: A Before and after Trial

Bonne

Mazuski

Sona

et al. 2015

Journal of the American College of Surgeons

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mentioning

confidence: 99%

Effectiveness of Minocycline and Rifampin vs Chlorhexidine and Silver Sulfadiazine-Impregnated Central Venous Catheters in Preventing Central Line-Associated Bloodstream Infection in a High-Volume Academic Intensive Care Unit: A Before and after Trial

Bonne

Mazuski

Sona

et al. 2015

Journal of the American College of Surgeons

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“…Some studies showed that education could be effective in reducing infection rates. Pérez-Parra et al, and Warren et al, demonstrated reduction of CRBSI rates from 4.22 to 2.94 and 4.90 to 2.1 episodes/1,000 catheter days, respectively, by using simple lectures and/or posters [30,31]. Other authors, who performed a pre-post interventional study by using an educational module, showed reduction in CRBSI rates by 66 % [27,32].…”

Section: Continuous Education and Training Of Healthcare Workersmentioning

confidence: 96%

Innovative Strategies for Preventing Central-Line Associated Infections

Bouza

Guembe

Pérez‐Granda

2013

Curr Treat Options Infect Dis

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Opinion statementIn recent years, healthcare associated infections (HAIs), and central line-associated bloodstream infections in particular (CLABSI), are being viewed as "preventable" events. It has been estimated that up to 70 % of CLABSI episodes may be preventable with the implementation of evidence-based strategies pretending to reach the zero incidence. The most effective procedures, which have demonstrated to reduce significantly CLABSI rates, are preventive bundles, which consists of a set of measures to be carried out during both catheter insertion and maintenance. These measures are mainly the following: implementing continuous education and training of healthcare personnel workers, using maximal sterile barrier precautions during insertion, performing skin disinfection with 2 % alcoholic chlorhexidine, avoiding the femoral site, and removing unnecessary catheters. However, these strategies have been performed mainly in the intensive care units (ICUs) with much less emphasis and efforts in non-ICU wards. There is also a need to introduce other novel strategies to reduce the CLABSI rates such as using catheter lock antiseptic solutions, using antiseptic impregnated sponges and dressings, designating a surveillance nurse to monitor central lines, or keeping a record of the insertion and maintenance procedures using a checklist.

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“…The educational methods chosen should take into consideration the preferred methods of learning, principles of adult education, resources available, cultural norms, and languages spoken by health care personnel. 15,47,48 Engagement of the patient and family in CVC care bundles is imperative. Central venous catheter line rounds facilitated by nursing champions can be an important tool in CLABSI prevention.…”

Section: Strategies To Increase Compliance With Bundle Elementsmentioning

confidence: 99%

Pediatric central venous access devices: nursing interventions

Duffy¹,

Nelson²

2017

NRR

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A central venous catheter (CVC) is an indwelling catheter that provides permanent or temporary stable venous access for both acute and chronically ill pediatric patients. These catheters provide stable venous access that can be used for a variety of medical purposes including drawing blood, hemodynamic monitoring, infusion of intravenous medications, infusion of intravenous fluids, chemotherapy, blood products, and parenteral nutrition. Each day, nurses access and care for CVCs in infants, children, and adolescents; the precision of this care can prevent life-threatening complications. The purpose of this review and the case study is to highlight the importance and components of evidence-based nursing practice in pediatric CVC care. A historical perspective of CVC care is provided in conjunction with current national initiatives to improve patient outcomes for children with CVCs. Infection prevention, clinical practice guidelines, quality improvement, and evidence-based care bundles are discussed. Keywords: pediatric nursing, central venous catheters, central line-associated bloodstream infection, care bundles, pediatric case study Case studyRyker is a previously healthy 9-year old boy. He was brought to the emergency department by ambulance after being hit by a car while riding his bicycle. His injuries included fractures of the pelvis and femur, a pulmonary laceration, and a laceration of spleen. He required multiple surgeries to manage his injuries. During his second surgery, a right subclavian central venous catheter (CVC) was placed. This catheter provides stable venous access for administration of fluids, medications, and labs during his recovery. On hospital day #10, Ryker developed a fever, and labs and blood cultures were drawn. His labs were significant for a white blood cell count of 22,000 cells/mm 3 . The initial gram stain of his blood revealed gram-positive cocci in clusters with a culture positive for coagulase-negative staphylococcus. Ryker was started on antibiotics and his CVC was removed. He continued to recover from his injuries, and he responded well to treatment with antibiotics for his bloodstream infection. He was discharged to an inpatient rehabilitation program on hospital day #18.After further review, and ruling out other potential sources of infection such as a urinary tract infection, surgical site infections, and pulmonary infections, Ryker's positive bloodstream infection was classified as a central line associated-bloodstream infection (CLABSI) using the Center for Disease Control and Prevention (CDC) criteria. This health care-associated infection (HAI) triggered a review by the health care team. Physicians, nurses, respiratory therapists, pharmacists, and other interdisciplinary staff Correspondence: elizabeth A Duffy

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A Simple Educational Intervention to Decrease Incidence of Central Line–Associated Bloodstream Infection (CLABSI) in Intensive Care Units with Low Baseline Incidence of CLABSI

Cited by 40 publications

References 12 publications

Effectiveness of Minocycline and Rifampin vs Chlorhexidine and Silver Sulfadiazine-Impregnated Central Venous Catheters in Preventing Central Line-Associated Bloodstream Infection in a High-Volume Academic Intensive Care Unit: A Before and after Trial

Effectiveness of Minocycline and Rifampin vs Chlorhexidine and Silver Sulfadiazine-Impregnated Central Venous Catheters in Preventing Central Line-Associated Bloodstream Infection in a High-Volume Academic Intensive Care Unit: A Before and after Trial

Innovative Strategies for Preventing Central-Line Associated Infections

Pediatric central venous access devices: nursing interventions

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