Infusion Therapy Team and Dressing Changes of Central Venous Catheters

Abi-Said, Dima; Raad, Issam; Umphrey, Jan; Gonzalez, Virginia; Richardson, Deborah; Marts, Kathy; Höhn, D.

doi:10.1086/501597

Cited by 46 publications

(37 citation statements)

References 9 publications

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“…Maintain aseptic technique for the insertion and care of intravascular catheters [22,71,201,202]. Category IA B.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

“…Leave peripheral venous catheters in place in children until IV therapy is completed, unless complications (e.g., phlebitis and infiltration) occur [174,175,222,223]. Category IB E. When adherence to aseptic technique cannot be ensured (i.e., when catheters are inserted during a medical emergency), replace all catheters as soon as possible and after no longer than 48 hours [22,71,201,202]. Category II F. Use clinical judgment to determine when to replace a catheter that could be a source of infection (e.g., do not routinely replace catheters in patients whose only indication of infection is fever).…”

Section: Category Ib II Surveillancementioning

confidence: 99%

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Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

631

843

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These guidelines have been developed for practitioners who insert catheters and for persons responsible for surveillance and control of infections in hospital, outpatient, and home health-care settings. This report was prepared by a working group comprising members from professional organizations representing the disciplines of critical care medicine, infectious diseases, health-care infection control, surgery, anesthesiology, interventional radiology, pulmonary medicine, pediatric medicine, and nursing. The These guidelines are intended to provide evidencebased recommendations for preventing catheter-related infections. Major areas of emphasis include 1) educating and training health-care providers who insert and maintain catheters; 2) using maximal sterile barrier precautions during central venous catheter insertion; 3) using a 2% chlorhexidine preparation for skin antisepsis; 4) avoiding routine replacement of central venous catheters as a strategy to prevent infection; and 5) using antiseptic/antibiotic impregnated short-term central venous catheters if the rate of infection is high despite adherence to other strategies (i.e., education and training, maximal sterile barrier precautions, and 2% chlorhexidine for skin antisepsis). These guidelines also identify performance indicators that can be used locally by health-care institutions or organizations to monitor their success in implementing these evidence-based recommendations.

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“…Maintain aseptic technique for the insertion and care of intravascular catheters [22,71,201,202]. Category IA B.…”

Section: Category Ib II Surveillancementioning

confidence: 99%

Section: Category Ib II Surveillancementioning

confidence: 99%

Guidelines for the prevention of intravascular catheter-related infections

O’Grady¹,

Alexander²,

Dellinger³

et al. 2002

American Journal of Infection Control

631

843

View full text Add to dashboard Cite

show abstract

“…Infusion therapy teams have been reported to decrease CRI rates. However, this may not be possible in the ICU and a recent study suggested that appropriately trained personnel might be as efficacious [94].…”

Section: Catheter Handlingmentioning

confidence: 99%

Overview of catheter-related infections with special emphasis on prevention based on educational programs

Eggimann

Pittet

2002

Clinical Microbiology and Infection

109

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Intra-vascular access is an unavoidable tool in sophisticated modern medical practice, and catheter-related infection remains a leading cause of nosocomial infections, particularly in intensive care units where it is associated with significant patient morbidity, mortality, and additional hospital costs. The incidence of catheter-related bloodstream infection ranges from 2 to 14 episodes per 1000 catheter-days. On average, microbiologically documented, device-related bloodstream infections complicate the use of a central venous line in three to five per 100 cases. But this represents only the visible part of the iceberg and most episodes of clinical sepsis are nowadays considered to be catheter-related. We briefly review the pathophysiology of these infections, highlighting the importance of the skin insertion site and the intravenous line hub as principal sources of colonization and infection. Principles of therapy are briefly addressed. A large proportion of these infections are preventable and this has been the objective of creating precise guidelines. It was recently suggested that the situation may evolve with the introduction of antibiotic/antiseptic-coated devices, whose impact on the epidemiology of antibiotic resistance remains to be determined. Recently, educational programs and/or a global preventive strategy based on the strict application of specific preventive measures and careful control of all factors associated with infection proved to be even more effective than coated devices in reducing rates of infection. Practical aspects regarding educational approaches will help clinicians to adapt and incorporate educational programs into clinical practice.

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“…Their recommendations are to wear a sterile cap, mask, gown and gloves after hand disinfection, to sufficiently disinfect the skin at the insertion site (at least for 30 seconds with 2% chlorhexidine) as well as to use a sufficiently large, sterile drape for the cannulation site [117], [118]. The importance of team training in CVC handling is emphasised [13], [119], [120]. …”

Section: Central Venous Accessmentioning

confidence: 99%