Best Practices to Prevent Catheter Related Bloodstream Infections
The United States Centers for Disease Control estimates that each year one in twenty hospital patients will contract a Healthcare Associated Infection (HAI). When further examined, the number of infected patients is approximately 1.7 million per year resulting in nearly 99,000 deaths (CDC, 2011). Due to numbers like this, healthcare organizations, professional associations, and patient advocacy groups have all launched initiatives showing a universal response to this national healthcare priority. Chief among these initiatives was the collaboration between The Society for Healthcare Epidemiology of America and the Disease Society of America. The SHEA-IDSA joint publication on HAI prevention builds a professional foundation for healthcare facilities in the Unites States to mitigate the risk of HAI infected patients. The prevention strategies begin by identifying the most common HAIs, their causes, and detailing the both the human and financial costs associated with HAIs. Using this information, SHEA and ISDA created prevention strategies to combat each HAI. This essay will follow the SHEA-IDSA template by detailing information on the most common Healthcare Associated Infection and provide detailing prevention strategies. According to the United States Centers for Disease Control and the SHEA-IDSA report, the most common Healthcare Associated Infection are Central Line Associated Blood Stream Infections or CLABSI. With nearly 50% of all ICU patients requiring a central line, the amount of recorded CLABSI infections is extremely high. The research on CLABSI indicates the most common pathogens are Staphylococcus Aureus, Enterococci, and Candida. To better understand the nature of CLABSI incident and therefore employ prevention strategies one must understand the dynamic of a central line. The National Healthcare Safety Network defines a central line as “a catheter whose tip terminated in a great vessel” (IHI, 2011). The catheter on a central line punctures the skin, which by default makes bacterial and fungal infections possible. Once the infection has entered the body it can spread to the blood stream. The infection can then cause hemodynamic changes possibly causing death of a patient. Proof of an infection is found in the recovery of a pathogen from a blood culture from a patient who had a central line (CDC, 2010). For declarative purposes, a pathogen not commonly present on the skin must only be found in one culture whereas a pathogen commonly found on the skin must be detected in two or more cultures. In order to be confirmed as a central line infection, the central line must have been installed a minimum of two days prior to the development of the infection and there must be no other apparent source of the infection. Regarding the cost of Healthcare Associated Infections; both are indicators of the enormity of the problem. As mentioned earlier the 2010 CDC report titled “Preventing Healthcare-Associated Infections” stated 1.7 million cases occur each year in the United States. According to the same report 99,000 cases result in death. The Institute for Healthcare Improvement estimates that of these 99,000 deaths, up to 4,000 are a direct result of bloodstream infections. The human cost dwarves the financial costs, which alone have a crippling effect on the healthcare industry. Reflecting on the Institute for Healthcare Improvement report, each CLABSI incident prolongs hospitalization on average of seven days. Each infection costs between $3,700 and $29,000. Having established the common CLABSI incidents, identifying the risk of infection, and examining the cost, it is time to move into prevention strategies. The Institute for Healthcare improvement established the industry standard for central line infection strategies in what are known as Care Bundles. “The IHI “Central Line Bundle is a group of evidence-based...
Citations: Institute for Healthcare Improvement, IHI. (8/2/2011). Implementing the IHI Central Line Bundle. Retrieved from http://www.ihi.org/knowledge/Pages/Changes/ImplementtheCentralLineBundle.aspx
Institute for Healthcare Improvement
United States Centers for Disease Control and Prevention. (2011). Vital Signs: Central Line-Associated Blood Stream Infections United States, 2001, 2008, and 2009. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6008a4.htm
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