Central Line Associated Blood

Stream Infection Prevention in

non-ICU Settings

Erica Badillo, Natalie Farquharson, DeAngel Jones, Heather Smith

NUR/518

March 3, 2014

Cindy Boyer

Central Line Blood Stream Infections

• 250,000 CLABSIs occur annually

• Lead to higher mortality and morbidity rates

• Increase lengths of stay

Recommendations for CLABSI prevention in

any setting

• Continuing education

• Quality Assurance

Intravenous tubing protocols

Sterile technique

Recommendations for CLABSI prevention in

any setting

• Nurse-Patient Ratios

• Care Bundles

Hand Hygiene

Chlorhexadine dressings

Catheter hub disinfection

Removal of lines when medically permitted

TRUSTWORTHINESS & VALIDITY

• Credibility

• Transferability

• Dependability

TRUSTWORTHINESS & VALIDITY

• Validity

Conflict in research findings

• Gaps exists in the area of CLABSI’s in::

1. specificity of research

2. dedicated educational department

3. educational process

Confusion

• Confusion exists in the area of:

1.responsibility for central line maintenance

2. documentation of central line care

Research Utilization Process

Identification of the problem

In-depth literature review

Evaluation of previous studies to determine applicability of findings

Applicability of Findings

• Professional nurses share an obligation to review current literature

• Allows for clarification of the problem

• Evidenced-based standardized care

• Prevention initiatives, protocols, guidelines

• Goal- to improve patient care and patient outcomes

Assessing Applicability of the Findings

• The interventions and prevention strategies are applicable to multiple clinical settings

Findings were consistent in

multiple studies

• It is expected that these interventions will be just as effective at preventing infections in other settings

• A strong leadership team is vital to ensure staff compliance

• Many facilities have adapted a CLASBI prevention checklist.

Bundle interventions have been shown to significantly decrease

infection rates

Applying the research findings

Education

Support

Compliance

Procedure carts

Hand hygiene

Aseptic technique

Checklists

Guidelines IV team

Daily need assessments

Avoid femoral site

Chlorhexadine Line

maintenance

Culture of safety

Accountability

Quick removal

References:

• Centers for Disease Control and Prevention. (2014). Central Line-Associated Bloodstream Infection: Resource of Patients and Healthcare Providers. Retrieved February 2, 2014 from: http://www.cdc.gov/HAI/bsi/CLABSI-resources.html

• Kallen, A., Patel, P., O’Grady, N. (2010). Preventing catheter-related bloodstream

infections outside the intensive care unit: expanding prevention to new settings. Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society; 51 (3), 335-41.

• Morrison, T. (2012). Qualitative analysis of central and midline care in the

medical/surgical setting. Clinical Nurse Specialist; 26(6):323-8. doi:10.1097/NUR.0b013e31826e3f2a

• The Joint Commission. (2010). Preventing Central Line-Associated Infections. A

Global Challenge, A Global Perspective. Retrieved from http://www.jointcommission.org/assets/1/18/CLABSI_Monograph.pdf

References: