Cost-effectiveness of employing a total parenteral nutrition surveillance nurse for the prevention of catheter-related bloodstream infections

Quality and safety impact on the provision of parenteral nutrition through introduction of a nutrition support team

“…Previous studies demonstrated marked improvements in CRBSI rates following the introduction of an enhanced IV service, with or without simultaneous introduction of an NST alongside. [10][11][12]16,17,29 Factors leading to improved CRBSI rates implemented by the IV team included integrated ANTT training sessions, improved catheter choice and improved line care protocols. Further improvements were obtained after NST introduction through measures such as regular and repeated staff education programmes in aseptic techniques and optimising the choice of venous catheter used for PN; the latter included the increased use of peripherally inserted central catheters.…”

“…7 The NST may convert inappropriate PN referrals into enteral feeding, which, in a recent British study, was demonstrated in 41% of cases. 10 Further, reductions in the occurrence of CRBSI [10][11][12]16,17 and electrolyte disturbances 18,19 have been observed after NST introduction. It is unclear whether inappropriate PN referrals relate to medical or surgical specialties and whether the introduction of an NST influences the indications for referral, the number of patients referred or the mean duration of PN.…”

“…10 Catheter-related bloodstream infections (CRBSIs) and metabolic abnormalities have been described in up to 40% of parenterally fed patients. [10][11][12] A high frequency of inappropriate PN has been documented in both national surveys 13 and prospective regional studies. 14 It remains of prime importance to deliver PN safely to an appropriately selected patient group to optimise overall patient care.…”

Hospital Staffing and Health Care–Associated Infections: A Systematic Review of the Literature

“…In addition, 1 study found a decrease in BSIs after the introduction of a dedicated total parenteral nutrition surveillance clinical nurse manager. 18 Nurse Staffing and Multiple HAIs…”

Diagnosis and management of catheter-related bloodstream infections in patients on home parenteral nutrition

“…While a UK IFU has recently reported inpatient CRBSI rate of 0.04/1000 catheter days for new patients admitted to the unit over a 7-year period (over a total of 23 548 inpatient catheter days), it is apparent that the CRBSI rate can be much higher when patients are managed on general medical and surgical wards; for example, CRBSI rates of 5.1 per 1000 catheter days have been noted on medical-surgical ICUs, 5.8 per 1000 for trauma ICUs and 30.2 per 1000 for burn units 32 33. In the general surgical and medical ward setting, CRBSI rates have also been shown to vary, with some studies reporting rates as high as 20.5 per 1000 catheter days 34–36. Clearly, the type of line and clinical setting has a large impact on recorded CRBSI rates.…”