Clinical Guidelines on the Prevention of Catheter-related Bloodstream Infections

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Recommended: Catheter bloodstream infection and literature review

Because central venous catheters (CVCs), which are catheters inserted through a major vein with the tip resting near the heart, serve many purposes such as medication administration, parenteral nutrition, fluid therapy and central venous pressure measurement, their use has become increasingly common in the intensive care unit (ICU) (Polderman & Girbes, 2002). However, CVC use is associated with an increased risk for hospital-acquired infections (McLaws, Gold, King, Irwig, & Berry, 1988), with those in situ for more than six days contributing to increased infection rates compared to those in place for five days or less (McLaws & Taylor, 2003). Catheter-related bloodstream infection (CRBSI) is defined as a laboratory-confirmed bloodstream infection more likely caused by a CVC in place during or within 48 hours of insertion (Centers for Disease Control and Prevention, 2012). Increased expenditures associated with CRBSI episodes due to mechanical ventilation use and lengthened stay in the ICU can significantly impact the individual and unnecessarily tax an already burdened healthcare system (Blot et al., 2005).

Elderly patients, a particularly vulnerable population, may be predisposed to higher rates of CRBSI because the break in skin barrier may expose the bloodstream to the environment (Richard, 2001). Trauma sustained from injuries can also contribute to a weakened immune system, thus rendering one susceptible to infection (Richard, 2001). Nurses, as members of the interdisciplinary health team, play an essential role in preventing infection arising from CVC use. Minimising the occurrence of CRBSI can result in reduced costs, decreased length of hospitalisation, and more positive health outcomes. In this essay, the writer will di...

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...A., Canals, M., . . . Morón, A. (2008). Prospective Randomized Trial of 3 Antiseptic Solutions for Prevention of Catheter Colonization in an Intensive Care Unit for Adult Patients. Infection Control and Hospital Epidemiology, 29(9), 847-853.

Yébenes, J. C., Vidaur, L., Serra-Prat, M., Sirvent, J. M., Batlle, J., Motje, M., . . . Palomar, M. (2004). Prevention of catheter-related bloodstream infection in critically ill patients using a disinfectable, needle-free connector: A randomized controlled trial. American journal of infection control, 32(5), 291-295. doi: 10.1016/j.ajic.2003.12.004

Zingg, W., Imhof, A., Maggiorini, M., & Stocker, R. (2009). Impact of a prevention strategy targeting hand hygiene and catheter care on the incidence of catheter-related bloodstream infections. Critical Care Medicine, 37(7), 2167-2173; quiz 2180. doi: 10.1097/CCM.0b013e3181a02d8f

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