Catheter-related bloodstream infection (CRBSI) is defined as a bacterial infection in the blood that originates from an intravenous catheter.[9][13] Intravascular catheters are essential to modern day medical practices and are inserted in critically-ill patients for the administration of fluids, blood products and medication.[11] Central venous catheters (CVCs) pose as a major risk above all device-related infections and are major attributors of morbidity and mortality.[11] They are also the main source of bacteremia and septicemia in hospitalized patients. Patients are 64 times greater in developing a catheter-related blood stream infections as a result of central venous catheter use than with peripheral venous catheters.[12][13][14]
According to an article by Timsit, J., et al. an estimated 5 million central venous catheters are inserted in patients each year. CBIs, most of which are associated with central venous catheters, account for more than 11% of all health-care associated infections. Additionally, more than 250,000 central-line associated blood stream infections also occur annually, with an estimated mortality rate of 12-25%. For patients within the intensive care unit, the numbers were even higher. Each episode significantly increases the patient’s hospital stay, as well as increasing costs from $4,000 to $56,000 per episode.
The guidelines’ first focus is the definition of sepsis, which makes sense, because there is no way to effectively treat sepsis without an accurate and categorical definition of the term. The guidelines define sepsis as “the presence (probable or documented) of infection together with systemic manifestations of infection”. Such systemic manifestations can include fever, tachypnea, AMS, WBC >12k, among others; these manifestations are listed in full in Table 1 of the guidelines. The definition for severe sepsis builds on to the definition of sepsis, bringing organ dysfunction and tissue hypoperfusion (oliguria, hypotension, elevated lactate) into the picture; full diagnostic criteria is listed in Table 2. The guidelines recommend that all
Tesfahunegn Z, Asrat D, Woldeamanuel Y, Estifanos K (2009) Bacteriology of surgical site and catheter related urinary tract infections among patients admitted in Mekelle Hospital, Mekelle, Tigray, Ethiopia. Ethiop Med J. 47(2):117-27.
Ventilator Associated Pneumonia (VAP) is a very common hospital acquired infection, especially in pediatric intensive care units, ranking as the second most common (Foglia, Meier, & Elward, 2007). It is defined as pneumonia that develops 48 hours or more after mechanical ventilation begins. A VAP is diagnosed when new or increase infiltrate shows on chest radiograph and two or more of the following, a fever of >38.3C, leukocytosis of >12x10 9 /mL, and purulent tracheobronchial secretions (Koenig & Truwit, 2006). VAP occurs when the lower respiratory tract that is sterile is introduced microorganisms are introduced to the lower respiratory tract and parenchyma of the lung by aspiration of secretions, migration of aerodigestive tract, or by contaminated equipment or medications (Amanullah & Posner, 2013). VAP occurs in approximately 22.7% of patients who are receiving mechanical ventilation in PICUs (Tablan, Anderson, Besser, Bridges, & Hajjeh, 2004). The outcomes of VAP are not beneficial for the patient or healthcare organization. VAP adds to increase healthcare cost per episode of between $30,000 and $40,000 (Foglia et al., 2007) (Craven & Hjalmarson, 2010). This infection is also associated with increase length of stay, morbidity and high crude mortality rates of 20-50% (Foglia et al., 2007)(Craven & Hjalmarson, 2010). Currently, the PICU has implemented all of the parts of the VARI bundle except the daily discussion of readiness to extubate. The VARI bundle currently includes, head of the bed greater then or equal to 30 degrees, use oral antiseptic (chlorhexidine) each morning, mouth care every 2 hours, etc. In the PICU at children’s, the rates for VAP have decreased since the implementation of safety ro...
The topic that I chose is interventions used to reduce catheter-associated urinary tract infections (CAUTI). This type of infection is acquired from the use of a urinary catheter while in the hospital. According to the Institute for Healthcare Improvement, urinary tract infections are responsible for 40 percent of all hospital-acquired infections annually, with 80% of these hospital-acquired infections caused by use of indwelling urinary catheters. When any type of tubes or catheters are introduced into the body, it serves as a medium for infection. Urinary catheters are used during surgery to prevent injury to the bladder.
Catheter Acquired Urinary Tract Infections (CAUTIs) has become to be classified as one among the leading infections which most individuals end up being susceptible to acquire while at the hospital. Healthcare-associated or acquired infections (HAIs) are a significant cause of illness, death, and more often than not, have resulted to cost the tax payers potentially high medical expenses in most health care settings. ("Agency for Healthcare Research and Quality," para. 1) Due to this, 1 out of every 20 patients will end up with CAUTI within the US hospitals and this has caused Agency for healthcare research and quality (AHRQ) to embark on nationwide plans to help in the eradication and control of CAUTI incidences. ("Agency
A urinary tract infection (UTI) is an infection of the urinary tract. The urinary tract is the body's drainage system for removing wastes and extra water. Urinary tract infections can have different names, depending on what part of the urinary tract is infected. The infection can include the bladder, kidneys, ureters, or the urethra. If the infection is in the bladder it is called “cystitis” or a bladder infection. If the infection is in the kidneys is it called “pyelonephritis” or a kidney infection? If the infection is in the urethra it is called “urethritis”. Most urinary tract infections are bladder infections. Infections in the ureters are very rare. Everyone is at risk of getting a UTI allowing bacteria to grow in the urine that stays
We as a nurse should be aware about the causes, risk factors and complications about the nosocomial infections associated to catheterization. As it is found in various surveys and research that the catheter associated UTI is one of the most common and frequently occurring type of hospital acquired infection due to various risk factors and causes, we have to follow the guidelines and strategies for the prevention and management of those infection. Catheter associated UTI is the patient safety indicator by which we can improve the health care and provide patient safety and quality care. There is a vital role of nurses in improving health care system which is possible by following the principles and guidelines of assessment, surveillance and nursing management of the patient.
Central lines (CL) are used frequently in hospitals throughout the world. They are placed by trained health care providers, many times nurses, using sterile technique but nosocomial central line catheter associated blood stream infections (CLABSI) have been a dangerous issue. This is a problem that nurses need to pay particular attention to, and is a quality assurance issue, because CLABSI’s “are associated with increased morbidity, mortality, and health care costs” (The Joint Commission, 2012). There have been numerous studies conducted, with the objective to determine steps to take to decrease CLABSI infection rate, and research continues to be ongoing today. The problem is prevalent on many nursing units, with some patients at great risk than others, but some studies have shown if health care providers follow the current literature, or evidence based guidelines, CLABSIs can be prevented (The Joint Commission, 2012). The purpose of this paper is to summarize current findings related to this topic, and establish a quality assurance (QA) change plan nurses can implement for CL placement and maintenance, leading to decreased risk of nosocomial CLABSIs.
Hospital acquired infections are spread by numerous routes including contact, intravenous routes, air, water, oral routes, and through surgery. The most common types of infections in hospitals include urinary tract infections (32%), surgical site infections (22%), pneumonia (15%), and bloodstream infections (14%). ( book). The most common microorganisms associated with the types of infections are Esherichila coli, Enterococcus species, Staphylococcus auerus, Coagulase-negative staphylococci, or Pseudomonas aeruginosa.(secondary) Urinary tract infections occur when one or more of microorganisms enter the urinary system and affect the bladder and/or the kidneys. These infections are often associated improper catheterization technique. Surgical site infections occur after surgery in the part of the body where the surgery took place. These infections may involve the top of the skin, the tissue under the skin, organs, or blood vessels. Surgical site infections sometimes take days or months after surgery to develop. The infections can be cause by improper hand washing, dressing change technique, or improper surgery procedure. Pneumonia can also become a hospital acquired infection. Ventilator-associated pneumonia is a type of lung in...
Central line-associated bloodstream infections also known as CLASBI are infections that stem from microorganisms that spread from the catheter site to the surface of the catheter. To reduce the risk of infection, central lines should be medically necessary and shouldn’t be inserted for comfort. They are for administration of medication that cannot be given peripherally due to possible harm, or either for providing large volumes of blood and other fluids. Ways to prevent infections include making sure that sterile technique is followed, and bathing with chlorhexidine instead of povidone-iodine. Reassessment of needs for central lines is also critical when trying to prevent infection.
There have been an incidents of prolonged hospital stay due to central line infections putting patients at risk for mortality, morbidity, and increase in medical cost. When central lines are placed at bedside or in interventional radiology, the inserter is required to document the steps and sterile procedure that took place in the electronic health record. Furthermore, with weekly and as needed dressing changes, nurses are required to use central line bundles and document what was used (ex: Chloraprep, biopatch, tegaderm, etc.) to track how the dressing was done. From these documented records, staff can gather data and measure the compliance of sterile procedure. Additionally, if a patient with a central line develops a fever without an unknown cause physician will order blood culture from the central line if catheter-related infection is suspected. If the test comes back positive, the team will initiate antibiotics immediately. By integrating electronic health records it can assist in CLABSI prevention strategies, raise the standard for best practices, and essentially reduce central line infections. With the quarterly results of CLABSI in our unit, CVC committee have re-educated the staff on appropriate dressing changes using sterile technique, transitioned to a different end
surgical asepsis method when placing a catheter on a patient. Contamination of the catheter provides a path way in which microorganisms could enter the urinary system and caused an infection in the bladder or the kidneys. These types of infections usually occurs if health care provider doesn’t wipe or clean the perennial area form front to back microorganism like E coli will find an easy access to the Urinary tract and cause infections.
A urinary tract infection is a very common infection that can happen to anybody. A urinary tract infection usually occurs when bacteria enters the urethra and multiples in the urinary system. The Urinary tract includes the kidneys, the thin tubes that carry urine from the kidneys to the bladder (ureters), and the main tube that carries the urine from the bladder (urethra). Women, men, and children are all immune to this infection. Women have the highest chances of getting it. In the Urinary tract, the main links of the ureters help get rid of any bacteria that tries to enter the urine, and the bladder helps prevent urine from backing up into the kidneys.
Hospital-acquired bladder infections. These infections, occur in people in a medical care facility, such as a hospital or nursing home. Most often they happen in those who have had a urinary catheter placed through the urethra and into the bladder to collect urine, a common practice before surgical procedures, for some diagnostic test, or as a means of urinary drainage for older adults or people confined to bed.