1. By Denise Dixon

2. Catheter related blood stream infections (CRBSI) is a problem in our healthcare. Many clinicians and patients struggle to over come this epidemic. By identifying the problem we can begin to find a solution. There are many ways to prevent CRBSI, it could be as simple as hand washing or choosing the correct catheter and site.

3. To prevent Catheter Related blood Stream Infection (CRBSI) and Thrombus (blood clots) would size of the catheter, site of insertion, type of PICC line and care and maintenance effect the outc0me?

4. Findings: Size 3 French catheter 0 % chance of thrombus 4 French catheter 1.1 % chance of thrombus 5 French catheter 6.6% chance of thrombus 6 French catheter 9.8 % chance of thrombus Conclusion: the smaller the catheter the less chance of thrombus, which leads to decreased infection rates

5. Findings: Site Infection Rates Thrombus Rates Subclavian 1.2% Jugular 4.5% Femoral 15.3 % Conclusion: The subclavian site is optimal to decrease infection and thrombus rates Subclavian 1.9% Jugular 7.6% Femoral 21.5% * Tip of catheter should reside in the lower 1/3 of the Superior Vena Cava (SVC) to receive optimal results

6. Findings: Type of PICC line Occlusions Infections Proximal valve 1.4% Non- valved 6.3% Conclusion: Proximal valve overall better choice to prevent occlusions and infections Proximal valve 4.2 % Non-valved 5.5%

7. Findings: Techniques to reduce infection and thrombus in central venous catheters Proper hand washing Maximum barrier technique during insertion Appropriate disinfection prior to access to the line Appropriate site of insertion Avoid multiple replacements

8. Smaller French catheter offers better chance to reduce infection and thrombus. Subclavian site offers less chance of infection and thrombus. Proximal valve PICC line has lower occlusion rates and less chance of infection Proper technique will over all decrease catheter related blood stream infection and thrombus.