Catheters Give Life but Sometimes Take It

A study conducted at Banner Desert Hospital, in Mesa Ariz., sought to decrease CVC infections in the adult medical/surgical ICU by using literature from the CDC and IHI, and benchmarks from the National Institute of Health Services.⁴

Project leaders gathered initial data about the nature of central line infections with the help of a central line audit tool, which included aspects such as patient symptoms, cultures and culture sites, and the date the central line was placed.⁴ The central line audit tool was used to track the number and nature of infections after the central line bundle and safety checklists were instituted, writes Jeanette Meyer, MSN, RN, CCRN, CCNS, PCCN, in her paper, “Decreasing central line infections with evidence-based practice.”

The result was that in seven consecutive months after the practice change, no CVC infections were noted. The recommendation from Meyer’s paper is to continue using the central line bundle and safety checklists.

“Examine each specific infection that occurs in detail to attempt to determine causative factors,” Meyer writes. “Create specific criteria for evaluating line necessity and use this criteria in determining whether to maintain or discontinue central lines.”

Some research supports bundling, but the process should not be mandatory at every hospital, Perl says.

“It would be a shame to force reporting of something that is not supported by the literature,” Perl says. “While I think the bundle is important, these data are lacking. Also, we need to make sure people know that the bundle in itself will not prevent all CA-BSI—there are other reasons patients get these and we cannot forget these other important components of infection prevention programs.”ICT

References

1. Institute for Healthcare Improvement: Getting Started Kit: Prevent Central Line Infections, How-to Guide. www.ihi.org/ihi.

2. Hadaway LC. Best-practice interventions: keeping central line infection at bay. Nursing2006. April 2006

3. Centers for Disease Control and Prevention. Reduction in Central Line-Associated Bloodstream Infections Among Patients in Intensive Care Units: Pennsylvania, April 2001-March 2005. Oct. 2007.

4. Meyer JM. Decreasing central line infections with evidence-based practice. Academic Center for Evidence-Based Practice.