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Central Line Bloodstream Infection Essay

1562 words - 7 pages

Nosocomial central line bloodstream infections are becoming one of the lead causes of death within hospitals (Smith, Egger, Franklin, Harbrecht & Richardson, 2011, p.1038). A blood stream infection is defined as having a positive blood culture while central venous access is in place without any further evidence of infection related to the patient’s comorbidities (Smith, et al., p. 1038). Organisms that are known to cause these infections include staphylococcus aureus and enterobacteriaceal (Curry, Honeycutt, Goins & Gilliam, 2009, p.151). It is concluded that one in ten patients experience an adverse event such as a central line bloodstream infection during their stay at the ...view middle of the document...

The PICO question asked for the purpose of this research was: can the implementation and compliance of a central line insertion bundle and the related policy reduce the number of central line infections in inpatients in an acute care facility? Patient safety focus groups such as the Institute for Healthcare Improvement have identified the use of a central line insertion bundle as best practice for the reduction of central line associated bloodstream infections (Curry, Honeycutt, Goins & Gilliam, 2009, p.151). Evidence-based studies have come up with a general consensus of what should be included in this bundle. The bundle should include a maximum sterile barrier, CHG cleanser, meticulous hand hygiene policy, insertion supplies (including the central line catheter), procedure checklist and daily post evaluation of the patient’s need for the central line as well as daily assessments of the lines patency and securement of the dressing (Curry, et al., p.151). In one study, using the above mentioned insertion kit reduced a hospitals central line infections by greater than fifty percent, from twenty infections in 2005 to only seven in 2011(Curry, et al., p.153). Another study that utilized the bundle saw a decrease infection rate of more than seventy five percent from 7.7 infections per one thousand days to only 1.4 (Stevens & Schulman, 2012, p.101). Systematic reviews of bundling procedures such as the one done by Memel, proved that among institutions that have the lowest central line infection numbers, the common fact is that they all use an insertion bundle and subsequent policies for the central line care (Miller-Hoover & Small, 2009, p. 194).
While the insertion bundle is a common well adapted process used by several institutions, what the institution choses to put within a bundle may be different based on the current best practice policies researched. In one study, an institution found their central line blood infection rate decrease by one hundred percent by using a standardized bundle (McPeake, Cantwell, Malcolm & Malcolm, 2012, p. 124). Their bundle included the following: checklist for insertion, meticulous hand hygiene and sterile personal protection equipment (gown, gloves, mask, and eyewear), proper preparation of site with sterile CHG, sterile drape, sterile insertion equipment and a subsequent checklist for nursing staff to monitor insertion procedure (McPeake, et al., p. 124). The institution using this particular bundle started with nineteen infections in one year, and after the implementation of the bundle went more than three hundred days without an infection (McPeake, et al., p. 124). Another similar study evaluated the changes noted in infection rates when using a strict bundling protocol which not only included the material items but also an educational program (Duane, Brown, Borchers, Wolfe, Malhotra, Aboutanos & Ivatury, 2009, p.1167 ). While this study did show a decrease in...

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