Catheters Give Life but Sometimes Take It

Reducing catheter-related infections is vital, but doing so requires staff members to implement changes. Employees meet these changes with any mix of hope or doubt. Attitude depends on the institution and the people, and whether they think there is even a problem to correct, Perl says. “So you see a myriad of attitudes and these attitudes depend on the safety climate, the leadership and the engagement of leadership and the clinical/medical perception of the problem,” she adds. “Finally, I think that the amount of personal accountability organizations place on healthcare workers affects their perception of the problem and their willingness to participate in solutions.”

The Bundle

The Institute for Healthcare Improvement (IHI)’s 100,000 Lives Campaign seeks to prevent catheter-related bloodstream infections by implementing components of care called the “central line bundle.” The central line bundle is a group of evidence-based interventions that are more effective together than alone. The bundle has five components:

Hand hygiene

Maximal barrier precautions

Chlorhexidine skin antisepsis

Optimal catheter site selection, with the subclavian vein as the preferred site for non-tunneled catheters

Daily review of line necessity, with prompt removal of unnecessary lines

1. Hand Hygiene

According to the IHI, caregivers tending central lines should wash their hands thoroughly before and after palpating catheter insertion sites; before and after inserting, replacing, accessing, repairing, or dressing an intravascular catheter; when hands are obviously soiled; before and after invasive procedures; between patients; before donning gloves and after removing them, and after using the restroom.