EBP: Prevent CLABSI

Alvernia University Student Nurses: Janessa Rasmus, Megan

Wensel, Susan McAllister, and Jessica Beeck

Learning Objectives

• Analyze factors which affect occurrence of CLABSI

• Describe how CLABSI affects patient outcomes

• Identify evidence-based nursing interventions to decrease

CLABSI

• Recommend techniques to decrease incidences of CLABSI

PICO Question

In hospitalized patients, what are the benefits

of using evidence-based nursing interventions

to prevent CLABSI in vascular access devices

compared to traditional infection prevention

interventions?

What is CLABSI?

• Central line associated blood stream infection

• “A CLABSI is a primary bloodstream infection…that develops in a patient

with a central line in place within the 48-hour period before onset of the

bloodstream infection that is not related to infection at another site”

• (The Joint Commission, 2012, p. 7)

Factors Affecting Occurrence of CLABSI

• Short staffing and higher nurse to patient ratios

• Knowledge deficits of new staff members

• Poor standards of practice and staff complacency

Effects of CLABSI on Patient Outcomes

• Infections will cause a prolonged length of stay for patients (7-21 days)

• Prolonged length of stay causes increased cost of healthcare, ranging from

$7,000.00-$29,000.00

• CLABSI can cause a rise in mortality rate as high as 23%

Antimicrobial Lock Therapy

Chlorhexidine Gel Dressing

Evidenced-Based Nursing Interventions to

Prevent CLABSI

• Implementation of antimicrobial lock therapy can decrease CLABSI rates by

69%

• Chlorhexidine gel dressings can be used to prevent CLABSI in vascular

access devices

• Scrubbing the skin with chlorhexidine prior to line insertion can decrease

CLABSI by reducing skin flora

What is “HANDS?”

• H: Hand hygiene

• A: Antisepsis with 2% chlorohexidine gluconate in 70% isopropyl alcohol

• N: Non-touch technique

• D: Daily inspections ( “Is it still needed), Date on a dressing, Documentation

• S: Scrub the hub for 15 seconds and allow to dry

Nursing Techniques to Decrease CLABI

• Implement use of “HANDS” into nursing care

• Advanced certification for nurses working in critical care units and stepdown

units

• Verify that venous access device is still needed

References

• 3M. (2014). 3M™ Tegaderm™ CHG Chlorhexidine Gluconate I.V. Securement Dressings [Brochure]. Author. Retrieved from http://multimedia.3m.com/mws/media/501550O/tegaderm-chg-dressing-product-brochure.pdf

• The Joint Commission. Preventing Central Line–Associated Bloodstream Infections: A Global Challenge, a Global Perspective. Oak Brook, IL: Joint Commission Resources, May 2012. http://www.PreventingCLABSIs.pdf.

• http://www.jointcommission.org/assets/1/18/clabsi_monograph.pdf

• http://www.jointcommission.org/assets/1/6/CLABSI_infographic_final.pdf