Presentation on theme: "Background 250,000 Central Veneous Catheter (CVC) related blood stream infections occur in the United States each year, with a mortality of 12% to 25%"— Presentation transcript:
1Preventing Central Line-Associated Bloodstream Infection (CLABSI) at Community Medical Center
2Background250,000 Central Veneous Catheter (CVC) related blood stream infections occur in the United States each year, with a mortality of 12% to 25% per infection30,000 to 48,000 patients die each year as a result of CLABSI’s-That’s 248 plane crashes a yearEach CLABSI cost an average of $3,700 to $25,000Increasing the length of hospital stay by an average of 7 days.
3Background continued For 2008 CMC had 9 central line infections. That is 9 to manyDo you want one of your family members to be one of those 9?
4Risk Factors Prolonged hospitalization before catheterization Prolonged duration of the catheterizationInternal jugular catheterizationFemoral catheterizationEnvironment: Bacteria lives on walls, floors, side bed rails…Microbial colonization at insertion siteMicrobial colonization of thecatheter hub
5CMC is raising the barNationwide efforts are trying to reduce preventable deaths in hospitals and CMC is in the fore front of this initiationOne of the ways identified to help reduce central line associated bloodstream infections (CLABSI) is by “Bundling” our central line procedure.Bundling is taking 3-5 evidenced based practices or precautionary steps and put them together and implementing them togetherWhen all of the practices/precautionary steps are done together the results equal improved quality patient care
6Central line BundlingThe Central Line Safety Checklist & The Central Line Maintenance Sheet is attached to the central line insertion kitUse it for central line insertion and maintenanceFax both sheets after insertion to Infection , then turn it in to your managerHand HygieneWash hands before donning on gloves and after procedure
7Central line bundle continued Maximal Barrier PrecautionsNew Central Line Supplement kit will be used in addition to the central line insertion kitIt will include sterile: cap (2), gown (2), mask (2), medication labels, Chlorhexidine swab (1), central line SorbaView Securement dressing (1), and a Biopatch (1)Cover patient head to toe with the fenestrated section at the insertion siteThe subclavian is the optimal insertion site (femoral and jugular is not recommended by CDC, it increases the risk of infection.)Physician and assistant: Wear cap, gown, sterile gloves and mask.After insertion:Place Biopatch at insertion site, then secure with the SorbaView Securement dressingDo not suture central line in patientIt increases patient discomfort and increase risk for infection
8ChlorhexidineThe formulation of 2% CHG and 70% Isopropyl alcohol. They work together to provide the most rapid and persistent antimicrobial activity on the skin surface and acts fast on a broad spectrum of bacteria, including Methicillin-resistant Staphylococcus aureus (MRSA), and keeps fighting bacteria for at least 48 hours. It supports infection control guidelines for helping to reduce the incidence of blood stream infectionsTo usePinch the wings on the swab and releaseGently press the sponge against the treatment areaApply friction rub for 30 seconds on the upper torso and allow to dry for 30 secondsFor lower torso rub for 2 minutes and allow to dry for 1 minuteImportant ReminderDo not use on pediatrics weighing less than 1000 grams and do not use on pediatrics who do not have good skin integrity
9Biopatch Precautions: Benefits: Important points to remember: Broad Spectrum antimicrobial and antifungal agentContinually releases chlorhexidine gluconate for 7 daysAbsorbs up to 8 times it’s own weightBIOPATCH is proven to reduce CLABSI’s by 60% in patients with central venous cathetersPrecautions:Do not use on pediatrics weighing less than 1000 grams and do not use on pediatrics who do not have good skin integrityDo not place on infected wounds. It is not intended to be used as a treatment of percutaneous infectionsImportant points to remember:PLACE SHINY SIDE UPTo be used on all central line insertions and changed when dressing change occurs (EVERY 7 DAYS)
10Securement Dressing Do not suture central line into patient as this : Increases patient discomfortIncreases risk for infectionSuturing increases risk of needle stickChange Securement dressing every 7 days(use central line dressing change kit)
11Daily Review of Central line Document on Central line flowsheetCentral line insertion dateDaily assessment of insertion site (each shift)Evaluate all central lines daily with physician and remove nonessential linesWe are all an essential piece in preventing infections.Help out patients get the best quality care here at CMC and be a role model to other hospitalsReferences:CDC, 1000 Lives CampaignInstitute for Healthcare Improvement: Implement the Central Line /IHI/Topics/Critical Care/intensive Care/Changes, last accessed 4/09Society of Healthcare Epidemiology of America , Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute Care Hospitals 2008Last accessed 4/09PP by Scappel 09
12References CDC, 1000 Lives Campaign Institute for Healthcare Improvement: Implement the Central Line Care/intensive Care/Changes last accessed 4/09Society of Healthcare Epidemiology of America , Strategies to Prevent Central Line-Associated Bloodstream Infections in Acute Care Hospitals 2008hhtp://www.medicinenet.com/mrsapicture_slideshow/article.htm Last accessed 4/09PP by Scappel/Jshaw 09